The treatment and prevention of knee osteoarthritis: a tool for clinical decision-making

TY - JOUR

T1 - The treatment and prevention of knee osteoarthritis: a tool for clinical decision-making

AU - Bliddal, Henning

AU - Christensen, Robin

N1 - Keywords: Dietary Supplements; Exercise Therapy; Humans; Obesity; Osteoarthritis, Knee; Pain; Practice Guidelines as Topic; Randomized Controlled Trials as Topic; Societies, Medical; Weight Loss

PY - 2009

Y1 - 2009

N2 - BACKGROUND: Osteoarthritis (OA) is a major cause of disability, which will increase further with longer lifetime and higher average weight of the population. OBJECTIVE: To review a hierarchy of interventions for OA in clinical practice, and compare it with the Strength of Recommendation (SOR) proposed by the Osteoarthritis Research Society International (OARSI). METHODS: Search for relevant randomized controlled trials in databases, as well as published systematic reviews and meta-analyses. RESULTS/CONCLUSIONS: Preventive measures are few and uncertain; however, basic therapy includes reduction in weight in the obese and exercises to keep in shape; this is in accordance with the OARSI guidelines (OARSI, 100% consensus) emphasizing the need for obese individuals with knee OA to lose weight (OARSI, SOR = 96%). There are indications of an effect of some nutraceuticals, though further studies are needed for validation (OARSI, SOR = 63%). Pharmacological treatment has paracetamol as primary prescription, which is a safe, albeit weak analgesic. Supplementary medications are prescribed according to level of pain and possible inflammation.

AB - BACKGROUND: Osteoarthritis (OA) is a major cause of disability, which will increase further with longer lifetime and higher average weight of the population. OBJECTIVE: To review a hierarchy of interventions for OA in clinical practice, and compare it with the Strength of Recommendation (SOR) proposed by the Osteoarthritis Research Society International (OARSI). METHODS: Search for relevant randomized controlled trials in databases, as well as published systematic reviews and meta-analyses. RESULTS/CONCLUSIONS: Preventive measures are few and uncertain; however, basic therapy includes reduction in weight in the obese and exercises to keep in shape; this is in accordance with the OARSI guidelines (OARSI, 100% consensus) emphasizing the need for obese individuals with knee OA to lose weight (OARSI, SOR = 96%). There are indications of an effect of some nutraceuticals, though further studies are needed for validation (OARSI, SOR = 63%). Pharmacological treatment has paracetamol as primary prescription, which is a safe, albeit weak analgesic. Supplementary medications are prescribed according to level of pain and possible inflammation.

U2 - 10.1517/14656560903018911

DO - 10.1517/14656560903018911

M3 - Journal article

C2 - 19537998

SN - 1465-6566

VL - 10

SP - 1793

EP - 1804

JO - Expert Opinion on Pharmacotherapy

JF - Expert Opinion on Pharmacotherapy

IS - 11

ER -