Osteoarthritis: Which Treatments Work and Wh...(ofsupport (expressed as a percentage out...),Health

-- Nonpharmacologic -- These 11 recommendations include education and

self-management (97%); regular telephone contact (66%); referral to a

physical therapist (89%); aerobic, muscle strengthening and water-based

exercises (96%); weight reduction (96%); walking aids (90%); knee

braces (76%); footware and insoles (77%); thermal modalities (64%);

transcutaneous electrical stimulation (58%); and acupuncture (59%).

-- Pharmacologic -- These eight recommendations include acetaminophen

(92%); non-selective and selective oral nonsteroidal anti-inflammatory

drugs (NSAIDs) (93%); topical NSAIDs and capsaicin (85%);

intraarticular injections of corticosteroids (78%); intraarticular

injections of hyaluronans (64%); glucosamine and/or chondroitin

sulphate for symptom relief (63%); glucosamine sulphate, chondroitin

sulphate and/or diacerein for possible structure-modifying effects

(41%); and the use of weak opioids and narcotic analgesics for the

treatment of refractory pain (82%).

-- Surgical -- These five recommendations include total joint replacement

(96%); unicompartmental knee replacement (76%); osteotomy and joint

preserving surgical procedures (75%); joint lavage and arthroscopic

debridement in knee OA (60%); and joint fusion as a salvage procedure

when joint replacement had failed (69%).

"Our goal was to make these guidelines as simple as possible so that healthcare providers could determine which therapies would be most useful for an individual patient," says Dr. Francis Berenbaum, president elect of OARSI and a faculty member in the Department of Rheumatology at Pierre & Marie Curie University, APHP Saint-Antoine Hospi
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