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The Guidelines and Evidence Report recommends:
If those mechanical problems--such as loose bodies and meniscal tears - are present then arthroscopy can be potentially beneficial. "The current science shows us that just washing out the joint does not decrease the patient's osteoarthritis symptoms and can expose the patient to additional risk," said John Richmond, MD, Chair of the AAOS work group.
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Other important recommendations include:
"These two recommendations are very important because patients can self manage the progression of their OA, and take more control of what their issues are," said Dr. Richmond. "As far as losing weight, this has the highest potential to actually slow the progression of the disease."
After a thorough analysis of the current scientific literature, the work group recommends against using the following treatments:
The work group does suggest that patients with symptomatic OA of the knee receive one of the following analgesics for pain unless there are contraindications to this treatment:
In addition, the available evidence does not allow the work group to recommend for or against the use of:
Osteoarthritis (OA) of the knee is a leading cause of physical disability. Some 33 million Americans are affected by osteoarthritis, but it most commonly occurs in people who are 65years of age or older. OA of the knee can have a major effect on a person's ability to engage in daily activities like walking or climbing stairs. Symptoms associated with osteoarthritis of the knee include:
Several factors increase a person's risk of developing OA of the knee including:
"The Academy created this clinical practice guideline to improve patient care for those suffering from osteoarthritis of the knee," stated Dr. Richmond. "This serves as a point of reference and educational tool for both primary care physicians and orthopaedic surgeons, streamlining possible treatment processes for this ever-so common ailment."
Editor's Note: The AAOS guideline, was developed by an AAOS physician volunteer work group and was based upon a systematic review of the current scientific and clinical information on accepted approaches to treatment and/or diagnosis. The entire process included a review panel consisting of internal and external committees, public commentaries and final approval by the AAOS Board of Directors.
The full guideline along with all supporting documentation is available on the AAOS website: http://www.aaos.org/guidelines
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-- Not performing an arthroscopic lavage if a patient only displays symptoms of osteoarthritis and no other problems like loose bodies or meniscus tears.
SOURCE American Academy of Orthopaedic Surgeons
