Recommended Treatments for Knee Osteoarthritis

The American Academy of Orthopaedic Surgeons, the premier organization of orthopedic surgeons in the United States, formed a committee to evaluate the various treatments available for patients who have knee osteoarthritis. The committee scrutinized research on these treatments and looked at the quality of the research and the results of these studies.

The committee, formed of orthopedic surgeons, primary care physicians, physical therapists, and researchers, outlined their findings for physicians to guide treatment of knee osteoarthritis.

The full guidelines can be found on the AAOS website. Here is a summary.

Good Medical Evidence

The two most strongly supported treatments for knee osteoarthritis are weight loss and low-impact exercise. Patients who are overweight (BMI higher than 25) should aim to lose a minimum of 5% of their body weight. In addition, low-impact, aerobic exercise should be initiated in all patients with knee osteoarthritis.

Fair Medical Evidence

These treatments had some evidence for their use, but either the studies were of moderate quality or some of the results were conflicting. Either way, there is evidence that the following treatments may be helpful for patients with knee osteoarthritis:

  • Tylenol (Acetaminophen)
  • Non-steroidal anti-inflammatory medications (NSAIDs)
  • Cortisone injections

Evidence Is Insufficient For or Against Use

There are several treatments where the available research was insufficient to allow for a recommendation either for or against the use of these treatments. Patients with knee osteoarthritis should certainly be trying the aforementioned treatments before trying these less-proven treatments:

  • Knee braces
  • Viscosupplementation Injections(intra-articular hyaluronic acid, e.g., Synvisc, Orthovisc, and Hyalgan)
  • Acupuncture

Treatments Not Recommended

The report recommends that the following common treatments not be used because they have been shown to be ineffective in well-designed and well-executed medical research:

  • Custom orthotics for shoes
  • Glucosamine and/or chondroitin
  • Saline injections (needle lavage) of the knee joint

The report finds that these treatments have been shown in multiple, high-quality studies to be ineffective for relief of knee osteoarthritis symptoms.

Summary of Guidelines

These guidelines will undoubtedly unsettle many people who have found relief from osteoarthritis pain with treatments that did not score well in this report. These guidelines are not meant to upset these people, but rather to offer information about what treatments have been found to be most often successful in the treatment of knee osteoarthritis.

You should discuss these treatments with your physician, and ensure that he is taking all the necessary steps available to help relieve your arthritis pain.

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  • Richmond, JC, et al. "Guideline on the Treatment of Osteoarthritis (OA) of the Knee" American Academy of Orthopaedic Surgeons. Feb 2008.