Knee Osteoarthritis
OrthoEvidence’s Knee Osteoarthritis CoreView Page has been developed to effectively communicate the body of evidence
surrounding treatments where there is a lack of clarity. The aim of this page is to provide practitioners with a detailed review of the evidence within a topic
area so that they can make informed decisions regarding patient care.
Did you know that OA costs the healthcare industry over $60 billion each year?
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Key Insights
Based on the available evidence, we have a number of key insights on knee OA and the use of IAHA therapy.
Recommendations
IAHA therapy has been examined in 12 clinical practice guidelines. See how their recommendations differ.
Meta-analyses
Click on the corresponding button below to see the meta-analyses evaluating IAHA versus:
RCTs
Click on the corresponding button below to see the RCTs evaluating IAHA versus:
Key Insights
Based on the available evidence, we have a number of key insights on the use of PRP in knee OA.
Meta-analyses
Click on the corresponding button below to see the meta-analyses evaluating PRP versus:
RCTs
Click on the corresponding button below to see the RCTs evaluating PRP versus:
Key Insights
Based on the available evidence, we have a number of key insights on the use of knee bracing in knee OA.
Meta-analyses
We identified 1 meta-analyses examining knee bracing vs. a control intervention.
RCTs
View the ACE reports on the current clinical trial evidence comparing knee bracing to a control.
Key Insights
Based on the available evidence, we have a number of key insights on the use of NSAIDs.
Meta-analyses
Click on the corresponding button below to see the meta-analyses evaluating NSAIDs versus:
RCTs
Click on the corresponding button below to see the RCTs evaluating NSAIDs versus:
Key Insights
Based on the available evidence, we have a number of key insights on the use of corticosteroids in knee OA.
Recommendations
Corticosteroid therapy has been reviewed in 9 clinical practice guidelines.
Meta-analyses
Click on the corresponding button below to see the meta-analyses evaluating corticosteroids versus:
RCTs
Click on the corresponding button below to see the RCTs evaluating corticosteroids versus:
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Video Summary
Osteoarthritis Definition
Osteoarthritis is a frequent, slowly progressive joint disease characterized by the breakdown of cartilage,
bony changes of the joints, deterioration of tendons and ligaments, and inflammation of the joint lining.
References:
1. Srikulmontree, T. (May2015). Osteoarthritis. Retrieved from http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Osteoarthritis
Risk Factors for Osteoarthritis
There are a number of risk factors for osteoarthritis at both a person level and a joint-specific level .
References:
1. Neogi, T., & Zhang,Y.(2013). Epidemiology of osteoarthritis. Rheum Dis Clin North Am, 39(1),1-19.
Prevalence of Osteoarthritis
The prevalence of knee osteoarthritis is approximately 20-30 % in adult populations and is expected to rise due to an aging population.
Knee osteoarthritis is the most common cause of lower limb disability and has a significant direct and indirect economic effect,
having an estimated $60 billion impact on the US economy per year.
References:
1. Buckwalter, J.A., Saltzman, C., & Brown,T.(2004). The impact of osteoarthritis: implications for research. Clin Orthop Relat Res (427Suppl),S6-15.
2. Jordan, J.M., Helmick, C.G., Renner, J.B., Luta, G., Dragomir, A.D., Woodard, J., ...Hochberg, M.C.(2007). Prevalence of knee symptoms and radiographic and symptomatic knee osteoarthritis in African Americans and Caucasians: the Johnston County Osteoarthritis Project.J Rheumatol, 34 (1),172-180.
Diagnosis
Diagnosis may require a combination of both a clinical and radiographic examination.
Clinical
- Joint pain and discomfort
- Joint swelling
- Joint deformity
- Reduced physical function
Radiographic
- Narrowing of the cartilage
- Increase density of subchondral bone
- Presence of osteophytes
- Presence of subchondral cysts
- Joint malalignment
The correlation between the clinical presentation of the disease and radiographic changes varies considerably among patients.
The absence of radiographic changes should not exclude the diagnosis of osteoarthritis.
Alternatively, patients with radiographic changes indicative of osteoarthritis may be clinically asymptomatic or may not exhibit any disability.
References:
1. Buckwalter, J.A., Stanish, W.D., Rosier, R.N., Schenck, R.C., Jr., Dennis, D.A., & Coutts,R.D.(2001).The increasing need for non operative treatment of patients with osteoarthritis. Clin Orthop Relat Res (385), 36-45
2. Hinton, R., Moody, R.L., Davis, A.W., & Thomas, S.F. (2002). Osteoarthritis: diagnosis and the rapeutic considerations. Am Fam Physician, 65 (5), 841-848
Potential Issues with Diagnosis
- Length of time to diagnosis
- Resistance to seek diagnosis based on patient perceptions of doctors reactions due to lack of education
References:
1. Busby, H., Williams, G., & Rogers, A. (1997). 3. Bodies of knowledge: lay and biomedical understandings of musculoskeletal disorders. Sociology of Health & Illness, 19 (19B), 79-99
2. Neogi, T., & Zhang, Y. (2013). Epidemiology of osteoarthritis. Rheum Dis Clin North Am, 39 (1), 1-19
3. Paskins, Z., Sanders, T., & Hassell, A.B. (2013). What influences patients with osteoarthritis to consult their GP about their symptoms? A narrative review. BMC Fam Pract, 14, 195.