-- 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
|SOURCE Osteoarthritis Research Society International|
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