Arthroscopic Surgery for Knee Osteoarthritis

摘要

Sixteen international experts from four medical disciplines met to devise consensus guidelines for osteoarthritis of the knee and hip.3 Ranked by increasing "effect size" (the weighted mean difference or measurement of effectiveness used when comparing outcomes from different studies), the following treatments are beneficial for osteoarthritis pain of the knee: encouraging weight loss, acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDS) with gastroprotection, hyaluronate injections, topical NSAIDs or capsaicin, glucosamine sulfate (not glucosamine hydrochloride) 5, acupuncture, aerobic exercise, thermal modalities (ice or heat), and steroid injections. The guidelines published in BMJ Clinical Evidence generally agree with the above stated modalities, with the exception that acupuncture, capsaicin, and glucosamine are labeled as having unknown effectiveness.7 Opioid analgesics are not recommended as first-line agents for treatment, although many physicians prescribe them.3,7 On plain radiography, progression of disease does not correlate well with symptoms.8 Regarding surgical treatments, high tibial osteotomy for young and active patients with severe unicompartmental knee osteoarthritis may prolong time until joint replacement.