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Needle Lavage Not Effective for Knee Osteoarthritis

Posted Dec 24 2008 11:57am

Among the treatment options for osteoarthritis is needle lavage. This is using a needle and syringe to wash out foreign material from a joint. According to new guidelines on the treatment of knee osteoarthritis published by the American Academy of Orthopaedic Surgeons, needle lavage only provides benefit to patients with loose material in the joint or meniscal 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, M.D., who chaired the work group that penned the guidelines.

The guidelines, which included treatments up to but not including joint replacement, also recommend against arthroscopic surgery for lavage or debridement, which is removal of dead, damaged, or infected tissue. This is because the effects were not significant in the improvement in patient’s measure of pain or function.

There were other treatments that the study group recommended against since they provide no clinical benefit. These include:

  • Cusotom foot orthotics, such as lateral heel wedges
  • Gluscosamine hydrochloride
  • Chondroitin sulfate
  • Combinations of glucosamine and chondroitin

The group also recommends that patients who are overweight, with a body mass index greater than 25, should lose 5% of their body weight. Their analysis of patient data found that weight loss results in significant improvement in joint function and has the greatest potential to actually slow the progression of the disease.

Another recommendation is that patients participate in low-impact aerobics because of its significant impact on pain relief and disability.

The best treatments for pain include acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDS) as well as use of corticosteroids for short term use.

In addition, the group noted that available evidence did not allow recommendations for or against the use of bracing, acupuncture or intra-articular hyaluronic acid.

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