Medical Treatment of Knee Osteoarthritis
Several guidelines on the management of knee osteoarthritis (OA) have been published. This article will take into consideration the European League Against Rheumatism (EULAR) 2003 guidelines and the related literature published in 2004 and 2005. Paracetamol is the oral analgesic to try first in knee OA and, if successful, the preferred long term oral analgesic. Topical applications such as non-steroidal anti-inflammatory drugs (NSAIDs) and capsaicin have clinical efficacy and are safe. NSAIDs should be considered in patients unresponsive to paracetamol. Opioid analgesics, with or without paracetamol, are useful alternatives in patients in whom NSAIDs are contraindicated, ineffective, and/or poorly tolerated. Symptomatic slow acting drugs (glucosamine sulphate, chondroitin sulphate, unsaponifiable, diacerein, and hyaluronic acid) have symptomatic effects and may modify structure. Intra-articular injection of long acting corticosteroids is indicated for flare of knee pain, especially if accompanied by effusion.
Keywords : Knee osteoarthritis, medical treatment