HealthDay News — In the 2019 American College of Rheumatology/Arthritis Foundation Guideline, published online Jan. 6 in Arthritis Care & Research, updated recommendations are presented for the management of hand, hip, and knee osteoarthritis (OA).
Sharon L. Kolasinski, M.D., from the University of Pennsylvania School of Medicine in Philadelphia, and colleagues conducted a systematic review of the literature to update the 2012 recommendations for management of hand, hip, and knee OA.
Based on the available evidence, the authors made strong recommendations for exercise, weight loss in overweight or obese patients with knee and/or hip OA, self-efficacy and self-management programs, tai chi, and cane use. In addition, there were strong recommendations for hand orthoses for first carpometacarpal (CMC) joint OA, tibiofemoral bracing for tibiofemoral knee OA, topical nonsteroidal anti-inflammatory drugs (NSAIDs) for knee OA, oral NSAIDs, and intraarticular glucocorticoid injections for knee OA. Recommendations were conditional for balance exercises, yoga, cognitive behavioral therapy, acupuncture, thermal modalities, kinesiotaping for first CMC OA, orthoses for hand joints other than the first CMC joint, patellofemoral bracing for patellofemoral knee OA, and radiofrequency ablation for knee OA. Conditional recommendations were also made for topical NSAIDs, intraarticular steroid injections and chondroitin sulfate for hand OA, topical capsaicin for knee OA, and for acetaminophen, duloxetine, and tramadol.
“Optimal management requires a comprehensive, multimodal approach to treating patients with hand, hip, and/or knee OA offered in the context of shared decision-making with patients, to choose the safest and most effective treatment possible,” the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.