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Knee Osteoarthritis - exhaustive study by AAOS

post #1 of 2
Thread Starter 

http://www.sciencebasedmedicine.org/index.php/knee-osteoarthritis-thumbs-down-for-acupuncture-and-glucosamine/

 

"The American Academy of Orthopaedic Surgeons (AAOS) has just issued a 1200 page report evaluating the evidence for various treatments for knee osteoarthritis short of total knee replacement surgery."

 

Excerpt (emphasis in red mine, emphasis in bold theirs):

 

  1. Exercise – strong evidence for effectiveness
  2. Weight loss – moderate evidence for
  3. Acupuncture – strong evidence against
  4. Physical agents (TENS, ultrasound, etc.) – inconclusive
  5. Manual therapy (chiropractic, massage) – inconclusive
  6. Valgus-directing force brace – inconclusive
  7. Lateral wedge insoles – moderate evidence against
  8. Glucosamine and chondroitin – strong evidence against
  9. NSAIDs – strong evidence for
  10. Acetaminophen, opioids, pain patches – inconclusive (this is particularly interesting since acetaminophen is the standard first-choice drug)
  11. Intraarticular corticosteroid injections – inconclusive
  12. Hyaluronic acid injections – strong evidence against (and if injections are ineffective, those oral diet supplements certainly don’t have a chance)
  13. Growth factor injections and/or platelet-rich plasma – inconclusive
  14. Needle lavage – moderate evidence against
  15. Arthroscopy with lavage and debridement – strong evidence against
  16. Partial meniscectomy in osteoarthritis patients with torn meniscus – inconclusive
  17. Valgus-producing proximal tibial osteotomy – limited evidence
  18. Free-floating interpositional device – no evidence; consensus against
post #2 of 2

wowza. You know, a few years ago I had some possible meniscus issues and some patella grating and the like, I asked my physio if I should get it cleaned out and he was strongly against doing so. (Unless the meniscus was restricting my activity.) He reasoned that even if that stuff is a mess, it is still in there, and doing a better job than nothing at all, apparently.

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