Rheumatology

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The treatment and prevention of knee osteoarthritis: A tool for clinical decision-making
Expert Opinion in Pharmacotherapy, 06/24/09

Bliddal H et al. – Review focuses on increasing prevalence of degenerative diseases, related in part to steep increase in the prevalence of obesity. Need for more research into the associated osteoarthritis (OA) of weight-bearing joints is emphasized. Therapy may include dietary programs for weight loss as well as joint-saving exercises.

• Aim was to review a hierarchy of interventions for OA in clinical practice, and compare it with the Strength of Recommendation (SOR) proposed by the Osteoarthritis Research Society International (OARSI)
• Randomized controlled trials, published systematic reviews and meta-analyses were searched in databases

• Only a few preventive measures are available and they are uncertain
• Basic therapy includes:
  • Reduction in weight in the obese, and
  • Exercises to keep in shape
    
    in accordance with the OARSI guidelines (OARSI) emphasizing the need for obese individuals with knee OA to loose weight
• There are indications of an effect of some nutraceuticals, though further studies are needed for validation
• Pharmacological treatment: paracetamol as primary prescription, which is a safe, albeit weak analgesic
• Supplementary medications: prescribed according to level of pain and possible inflammation

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