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American Academy of Orthopaedic Surgeons (AAOS) Issues New Practice Guidelines for Treatment of Osteoarthritis of the Knee

Posted Mar 16 2009 3:43pm

Osteoarthritis of the Knee

  • Leading cause of physical disability

  • 33 million Americans affected

  • Most common in aged 65 or older

  • Affects activities of daily living like climbing stairs or walking


Symptoms include:

  • Pain

  • Joint stiffness

  • Swelling in knee


Factors that increase a persons risk of developing osteoarthritis:

  • Heredity

  • Weight

  • Age

  • Gender

  • Injuries or trauma to the knee

  • Poor posture or bone alignment

  • Lack of aerobic exercise and muscle weakness


The AAOS Guidelines and Evidence Report Recommendations:

AAOS recommends:

  • Patients should be encouraged to begin or increase their participation in low-impact aerobic fitness.

  • Patients who are overweight should lose a minimum of 5% of their body weight

  • Overweight is a body mass index (BMI) of greater than 25

    • you can calculate your own body mass index by multiplying your weight in pounds by 703 divided by your height in inches

    • Weight loss has the highest potential to slow the progression of osteoarthritis

  • AAOS recommends for pain control:

    • Tylenol

    • NSAIDs (common include ibuprofen and naprosyn)

    • Steroid injections into the knee like depomedrol or cortisone


  • AAOS recommends against:

    • Glucosamine and or chondroitin sulfate or hydrochloride

    • Drawing fluid from the knee with a needle

    • Custom made foot orthotics or foot supports

    • Performing a knee arthroscopy (knee scope) as a clean out procedure for arthritis when no other problems are present like loose bodies or cartilage tears

      •  "The current science shows us that just washing out the joint does not decrease the patient's osteoarthritis symptoms and can expose the patient to additional risk," said John Richmond, MD, chair of the AAOS work group.


  • AAOS does not recommend for or against:

    • Bracing

    • Acupuncture

    • Hyaluronic acid injections like synvisc or hyalgen


"AAOS Issues New Clinical Practice Guidelines for Osteoarthritis of the

Knee." American Academy of Orthopaedic Surgeons.   11 DEC.   2008

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