Italian Orthopaedic and Traumatology Society (SIOT) position statement on the non-surgical management of knee osteoarthritis.
Elisa PesareGiovanni VicentiElisaveta KonMassimo BerrutoRoberto CaporaliBiagio MorettiPietro S RandelliPublished in: Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology (2023)
For non-surgical management of knee OA, the recommended first step is to bring about lifestyle changes, particularly management of body weight combined with physical exercise and/or hydrotherapy. For acute symptoms, non-steroidal anti-inflammatory drugs (NSAIDs), topic or oral, can be used. Opioids can only be used as third-line pharmacological treatment. Glucosamine and chondroitin are also suggested as chronic pharmacological treatment. Regarding intra-articular infiltrative therapy, the use of hyaluronic acid is recommended in cases of chronic knee OA [platelet-rich plasma (PRP) as second line), in the absence of active acute disease, while the use of intra-articular injections of cortisone is effective and preferred for severe acute symptoms.
Keyphrases
- knee osteoarthritis
- platelet rich plasma
- anti inflammatory drugs
- hyaluronic acid
- body weight
- liver failure
- drug induced
- total knee arthroplasty
- cardiovascular disease
- respiratory failure
- chronic pain
- metabolic syndrome
- stem cells
- pain management
- weight loss
- type diabetes
- bone marrow
- depressive symptoms
- aortic dissection
- sleep quality
- mesenchymal stem cells
- combination therapy
- anterior cruciate ligament
- replacement therapy
- anterior cruciate ligament reconstruction
- extracorporeal membrane oxygenation