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

Expert Opin Pharmacother. 2009 Aug;10(11):1793-804. doi: 10.1517/14656560903018911.


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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Dietary Supplements
  • Exercise Therapy / methods
  • Humans
  • Obesity / complications*
  • Obesity / therapy
  • Osteoarthritis, Knee / prevention & control
  • Osteoarthritis, Knee / therapy*
  • Pain / drug therapy
  • Pain / etiology
  • Practice Guidelines as Topic*
  • Randomized Controlled Trials as Topic
  • Societies, Medical
  • Weight Loss