1 | The treatment of knee OA should be tailored to the individual patient, taking into account factors such as age, comorbidity, and the presence of inflammation |
2 | Optimal management of knee OA requires a combination of pharmacological and non-pharmacological treatment modes |
3 | Intra-articular injection of a long acting steroid is indicated for acute exacerbation of knee pain, especially if accompanied by effusion |
4 | There is evidence that SYSADOA (glucosamine sulphate, chondroitin sulphate, diacerein, and hyaluronic acid) may possess structure modifying properties, but more studies using standardised methods are required |
5 | Hyaluronic acid and other SYSADOA are probably effective in knee OA, but the size effect is relatively small, suitable patients are not well defined, and pharmacoeconomic aspects of this treatment are not well established |
6 | Non-pharmacological treatment of knee OA should include regular education, exercise, appliances (sticks, insoles), and weight reduction |
7 | Exercises, especially those directed towards increasing strength of quadriceps and/or preserving normal mobility of the knee, are strongly recommended |
8 | Paracetamol is the oral analgesic to try first and, if successful, is the preferred long term oral analgesic |
9 | NSAIDs (oral and topical) should be considered in patients (with effusion) unresponsive to paracetamol |
10 | Joint replacement has to be considered in cases of refractory pain associated with disability and radiological deterioration |