Knee osteoarthritis treatment

Abstract

Introduction. Osteoarthritis is the most common form of arthritis which affects millions of people worldwide and represents the leading cause of disability among the elderly. There is a substantial number of guidelines available for the treatment of knee osteoarthritis. The primary aim of this paper is to explore the distinctions and similarities between knee osteoarthritis treatment guidelines. The treatment is divided into core treatment and additional steps. Core treatment of knee osteoarthritis involves education of the patient, weight loss in the case of overweight patients and establishing an exercise program. First step of additional treatment of knee osteoarthritis consists of non-pharmacological (application of orthoses, lateral wedge insoles, assistive walking devices, therapeutic modalities, manual therapy, aquatic exercise, Tai chi) and pharmacological therapy (topical nonsteroidal anti-inflammatory drugs, topical capsaicin, paracetamol). Second step of additional treatment of knee osteoarthritis - pharmacological therapy should be considered if the first step didn?t show any significant results. It involves the use of oral nonsteroidal antiinflammatory drugs, intra-articular corticosteroid injections and viscosupplementation. Third step of additional treatment of knee osteoarthritis - last resort pharmacological therapy Pain occurring in knee osteoarthritis. can be partially caused by central sensitization. Because of that, use of duloxetine and tramadol may be considered. Fourth step of additional treatment of knee osteoarthritis-end stage treatment of knee osteoarthritis is reserved for the most severe patients. It includes total knee replacement surgery, and if it is not possible, treatment with strong opioids could be considered. Conclusion There are many possibilities in treatment of knee osteoarthritis. Unfortunately, there is often a lack of concordance between different guidelines. In these circumstances, treatment plans should be personalized, while comprehending potential risks and benefits.