Knee Osteoarthritis

This review is a pragmatic attempt to highlight recent research and some background reading in knee OA. It should not be considered exhaustive, simply a way of reviewing some of the major developments and current thinking in the area.

Click here to see all the TRIP Evidence Reviews.

Evidence-Based Reports

• Chondroitin ineffective for pain relief in severe knee osteoarthritis. POEMs, 2005
• Therapeutic knee taping improved pain and disability in osteoarthritis of the knee. Evidence-Based Medicine (Requires free registration), 2004
• Glucosamine may reduce pain in individuals with knee osteoarthritis. Rehabilitation Therapy CATs, 2005
• Does glucosamine or chondroitin reduce pain, improve functional status, or improve prognosis in patients with osteoarthritis? FPIN's Clinical Inquiries, 2006 View answer OR Can you answer the question for extra CPD?
• Topical diclofenac improved pain and physical function with no systemic side effects in primary osteoarthritis of the knee. Evidence-Based Medicine (Requires free registration), 2005
• Patient preferences for placebo, acetaminophen (paracetamol) or celecoxib efficacy studies (PACES): two randomised, double blind, placebo-controlled, crossover, clinical trials in patients with knee or hip osteoarthritis. Northern and Yorkshire Drug and Therapeutics Centre, 2004
• Weight loss for knee arthritis. Bandolier, 2005
• Topical NSAIDs for OA: update. Bandolier, 2005
• Acupuncture for osteoarthritis. Evidence-based Complementary and Alternative Medicine, 2004

Clinical Guidelines

• Osteoarthritis. PRODIGY, 2005
• AAOS clinical guideline on osteoarthritis of the knee. 2003
• AAOS clinical guideline on osteoarthritis of the knee (phase II). 2003
• Ottawa Panel evidence-based clinical practice guidelines for therapeutic exercises and manual therapy in the management of osteoarthritis. 2005

Systematic Reviews

• Retention versus sacrifice of the posterior cruciate ligament in total knee replacement for treatment of osteoarthritis and rheumatoid arthritis. Cochrane Database of Systematic Reviews, 2005
• Intra-articular hyaluronic acid (viscosupplementation) for knee osteoarthritis. Health Technology Assessment, 2006
• Aerobic walking or strengthening exercise for osteoarthritis of the knee: a systematic review. DARE, 2005
• Intraarticular corticosteroid for treatment of osteoarthritis of the knee. Cochrane Database of Systematic Reviews, 2006
• Viscosupplementation for the treatment of osteoarthritis of the knee. Cochrane Database of Systematic Reviews, 2006
• Glucosamine long-term treatment and the progression of knee osteoarthritis: systematic review of randomized controlled trials. DARE, 2005
• Cost-effectiveness of a supplementary class-based exercise program in the treatment of knee osteoarthritis. NHS EED, 2006
• Randomised controlled trial of the cost-effectiveness of water-based therapy for lower limb osteoarthritis. NCCHTA, 2005
• Glucosamine therapy for treating osteoarthritis. Cochrane Database of Systematic Reviews, 2005

Recent articles in core journals

• Prognostic factors of progression of osteoarthritis of the knee: A systematic review of observational studies. Arthritis Rheum, 2007 View answer OR Can you answer this related question for extra CPD?
• Effects of aquatic exercise on flexibility, strength and aerobic fitness in adults with osteoarthritis of the hip or knee. J Adv Nurs, 2007
• The cost effectiveness of behavioural graded activity in patients with osteoarthritis of hip and/or knee. Ann Rheum Dis, 2007
• A prospective, randomized, double-blind, placebo controlled study to evaluate the efficacy of intraarticular hyaluronic acid for osteoarthritis of the knee. J Rheumatol, 2006
• Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. NEJM, 2006
• Intensive weight loss program improves physical function in older obese adults with knee osteoarthritis. Obesity (Silver Spring), 2006
• Longterm efficacy of topical nonsteroidal antiinflammatory drugs in knee osteoarthritis: metaanalysis of randomized placebo controlled clinical trials. J Rheumatol, 2006

eTextbooks

• Ganfyd
• eMedicine
• Merck Manual
• GP Notebook

Clinical Queries

• What evidence is there that arthroscopic washout of the knee is beneficial in providing pain relief to those with osteoarthritis of the knee? For what length of time is this benefit, if any, is likely to last? ATTRACT, 2004
• What is the evidence for the effectiveness of hyaluronic acid injection for osteoarthritis (OA) of the knee? ATTRACT, 2006 View answer OR Can you answer the question for extra CPD?
• If a group of patients diagnosed with OA knee stop impact sports, is there any evidence to suggest that they will have less degenerative changes less disability or improved function compared to a similar patient group who continues with impact exercise? NLH Q&A Service, 2006
• Is there any evidence to suggest that trauma can accelerate osteo-arthritis? ATTRACT, 2006
• I vaguely recall some rules/guidelines on referral for osteoarthritic hips and knees regarding joint replacement. They allow scoring of patient and symptoms for surgery. I cannot recollect what they were called or where to find them. Can you help? NLH Q&A Service

Patient Information

• Arthritis Research Council
• NHS Direct Online
• BUPA Health Information
• Medline Plus