Osteoarthritis – Related resources

Cochrane reviews

• Interventions such as supervised or individualised exercise therapy and self-management techniques may enhance exercise adherence in short term .
• S-Adenosylmethionine (SAMe) seems not to reduce pain or improve function in osteoarthritis of knee or hip, although the evidence is insufficient .
• Valgus high tibial osteotomy (HTO) for medial compartment osteoarthritis of the knee appears to improve knee function and reduce pain but there is no evidence whether an osteotomy is more effective than conservative treatment, or which specific surgical technique should be used .
• Surgery for osteoarthritis at the base of the thumb improves pain, function, range of motion, and strength in the thumb and enhances well-being but there is no evidence on which type of surgery should be preferred .
• High intensity aerobic exercise may be as effective as low intensity exercise for patients with osteoarthritis of the knee .
• Electrical stimulation may have statistically significant effects for several outcomes, but the clinical significance of the benefit is uncertain .
• The effects of continuous passive motion (CPM) on knee range of motion appear to be too small to to be clinically worthwhile, but CPM may reduce the subsequent need for manipulation under anaesthesia.
• Valgus high tibial osteotomy (HTO) for medial compartment osteoarthritis of the knee appears to improve knee function and reduce pain but there is no evidence whether an osteotomy is more effective than conservative treatment, or which specific surgical technique should be used .
• Surgery for osteoarthritis at the base of the thumb improves pain, function, range of motion, and strength in the thumb and enhances well-being but there is no evidence on which type of surgery should be preferred .
• Diacerein has a mild beneficial effect in osteoarthritic pain and may slow the progress of osteoarthritis at least in the hip .
• Mineral baths seem to have beneficial effects compared to no treatment in patients with osteoarthritis, but the evidence is insufficient .
• Arthroscopic debridement appears to have no benefit for undiscriminated knee osteoarthritis .
• Early multidisciplinary rehabilitation after hip or knee joint replacement may improve outcomes at the level of activity and participation .
• Exercise may relief pain in patients with osteoarthritis of the hip but there is probaly no effect on self-reported physical function .
• Doxycycline appears not to be effective for the treatment of osteoarthritis of the knee or hip .
• Oral or transdermal non-tramadol opioids have small to moderate short-term beneficial effects on pain and function in patients with osteoarthritis of the hip or knee as compared with placebo. The benefits are, however, outweighed by large increases in the risk of adverse events .

Other evidence summaries

• Patient education appears not to be beneficial in reducing pain and disability in arthritis .
Chondroitin sulfate may relieve symptoms in patients with osteoarthritis of the hip and knee joints .
• Tricompartmental knee replacement may be a safe and effective procedure .
• Total knee replacement with unicompartmental of bicompartmental prostheses may yield moderately good results .
• Cemented prostheses appear to be the most cost-effective, with good prosthesis survival rates .
• The greatest volume of evidence is available for the Charnley prosthesis which may perform more favourably than comparison prostheses. The use of more expensive (cementless) prostheses seems hard to justify on limited current evidence .
• Resurfacing of the patella in total knee arthroplasty for osteoarthritis may reduce reoperation rates due to patellofemoral problems but may not reduce knee pain.
• Glucosamine seems to slow progression of knee osteoarthritis, but there is insufficient evidence from high-quality trials .

Clinical guidelines

• Guideline on the treatment of osteoarthritis (OA) of the knee (American Academy of Orthopaedic Surgeons)

Literature

• Lane NE. Clinical practice. Osteoarthritis of the hip. N Engl J Med 2007 Oct 4;357(14):1413-21.