Propositions of final recommendations based on the opinion of the experts
| Propositions | |
|---|---|
| 1 | Treatment of knee OA6-150 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 modalities |
| 3 | Intra-articular injection of long acting steroid is indicated for acute exacerbation of knee pain, especially if accompanied by effusion |
| 4 | There is evidence that SYSADOA6-150(glucosamine sulphate, chondroitin sulphate, diacerein, and hyaluronic acid) may possess structure modification properties, but more studies, using standardised methodology 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 that 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 | NSAIDs6-150(oral or topical) should be considered in patients (with effusion) unresponsive to paracetamol |
| 10 | Joint replacement has to be considered for refractory pain associated with disability and radiological deterioration |
↵6-150 OA = osteoarthritis; NSAIDs = non-steroidal anti-inflammatory drugs; SYSADOA = symptomatic slow acting drugs for osteoarthritis.