Treatment Guideline Chart

Osteoarthritis is a chronic progressive disease where there is degeneration and loss of articular cartilage that occurs together with new bone formation at the joint surfaces and margins that causes pain and deformity.

The patient experiences pain, stiffness, decreased movement, inflammation and crepitus.

The pain is usually aggravated by activities and relieved by rest.

Osteoarthritis References

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  2. Harvey WF, Hunter DJ. Pharmacologic interventions for osteoarthritis in older adults. Clin Getriatr Med. 2010 Aug;26(3):503-515. doi: 10.1016/j.cger.2010.03.008. PMID: 20699168
  3. National Collaborating Centre for Chronic Conditions (UK). Osteoarthritis: National clinical guideline for care and management in adults. Royal College of Physicians of London. 2008. PMID: 21290638
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  5. Zhang W, Nuki G, Moskowitz RW, et al. OARSI recommendations for the management of hip and knee osteoarthritis, part III: changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthritis Cartilage. 2010 Apr;18:476-499. http://www.oarsi.org/pdfs/part_III_changes_in_evidence2010.pdf. Accessed 14 Apr 2011
  6. Stanos SP. Osteoarthritis guidelines: a progressive role for topical nonsteroidal anti-inflammatory drugs. J Multidiscip Healthc. 2013 Apr;6:133-137. http://www.ncbi.nlm.nih.gov/pubmed/?term=Stanos+SP%09+Osteoarthritis+guidelines%3A+a+progressive+role+for+topical++nonsteroidal++anti-inflammatory++drugs. Accessed 11 Sep 2013. PMID: 23589694
  7. Zhang W, Moskowitz RW, Nuki G, et al. OARSI recommendations for the management of hip and knee osteoarthritis, part II: OARSI evidence based, expert consensus guidelines. Osteoarthritis Cartilage. 2008 Feb;16:137-162. http://www.oarsi.org/pdfs/oarsi_recommendations_for_management_of_hip_and_knee_oa.Pdf. Accessed 14 Apr 2011
  8. Sellam J, Berenbaum F. Clinical features of osteoarthritis. In: Firestein GS, Budd RC, Harris ED Jr, et al. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia: Elsevier W.B. Saunders; 2009
  9. Classification criteria for osteoarthritis of the hand. American College of Rheumatology. http://www.rheumatology.org/practice/clinical/classification/oa-hand/oshand.asp.Accessed. Accessed 14 Apr 2011.
  10. Combined clinical and radiographic classification criteria for osteoarthritis of the hip, traditional format. American College of Rheumatology. http://www.rheumatology.org/practice/clinical/classification/oa-hip/oahip.asp. Accessed 14 Apr 2011.
  11. Criteria for classification of idiopathic osteoarthritis (OA) of the knee. American College of Rheumatology. http://www.rheumatology.org/practice/clinical/classification/oaknee.asp. Accessed 14 Apr 2011.
  12. Kalunian KC. Diagnosis and classification of osteoarthritis. UpToDate. http://www.uptodate.com/contents/diagnosis-and-classification-of-osteoarthritis?detectedLanguage=en&source=search_result&search=gout+vs+osteoarthritis&selectedTitle=1~150&provider=noProvider. 2013. Accessed 11 Sep 2013.
  13. National Health and Medical Research Council. Guideline for the non-surgical management of hip and knee osteoarthritis. Australia: The Royal Australian College of General Practitioners. http://www.nhmrc.gov.au/_files_nhmrc/file/publications/synopses/cp117-hip-knee-osteoarthritis.pdf. Jul 2009. Accessed 14 Apr 2011.
  14. British Columbia Medical Association and British Columbia Ministry of Health Services. Osteoarthritis in peripheral joints - diagnosis and treatment. http://www.bcguidelines.ca/pdf/oa.pdf. Sep 2008. Accessed 14 Apr 2011.
  15. National Institute for Health and Care Excellence. Osteoarthritis: the care and management of osteoarthritis in adults. NICE. http://www.nice.org.uk/nicemedia/pdf/CG59NICEguideline.pdf. Feb 2008. Accessed 14 Apr 2011.
  16. Ministry of Health Singapore. Osteoarthritis of the knees. MOH (Singapore). http://www.moh.gov.sg/. May 2007. Accessed 14 Apr 2011.
  17. Structure modification in osteoarthritis - time to update the guidelines. Satellite symposium held at the 2009 European Congress of Rheumatology, European League Against Rheumatism (EULAR), Copenhagen. http://www.touchmusculoskeletal.com/files/article_pdfs/satellite_symposium.pdf. Accessed 14 Apr 2011.
  18. Jevsevar D, Brown GA, Jones DL, et al. Treatment of osteoarthritis of the knee: Evidence-based guideline. 2nd ed. American Academy of Orthopaedic Surgeons. http://www.aaos.org/research/guidelines/TreatmentofOsteoarthritisoftheKneeGuideline.pdf. May 2013. Accessed 22 Sep 2013.
  19. Access Economics Pty Limited. Painful realities: the economic impact of arthritis in Australia in 2007. Arthritis Australia. http://www.deloitteaccesseconomics.com.au/ uploads/File/Painful%20Realities%20-%20The%20economic%20impact%20of%20arthritis%20in%20Australia%20in %20 2007.pdf. 31 July 2007.
  20. Kalunian, KC. Investigational approaches to the pharmacologic therapy of osteoarthritis. UpToDate. http://www.uptodate.com/ contents/investigational-approaches-to-the-pharmacologic- therapy-of-osteoarthritis. 23 Oct 2013. Accessed 07 Mar 2014.
  21. National Institute for Health and Care Excellence. Osteoarthritis: care and management in adults. Clinical guideline 177. NICE. http://www.nice.org.uk/guidance/cg177/resources/guidance- osteoarthritis-pdf. Feb 2014. Accessed 08 Aug 2014.
  22. Rachala SR, Sierra RJ. Unicompartmental, bicompartmental, or tricompartmental arthritis of the knee: algorithm for surgical management. In: Scott N, Scuderi G. Insall & Scott surgery of the knee. Philadelphia, PA: Churchill Livingstone, Elsevier; 2012. Accessed 07 Mar 2014.
  23. Scarpignato C, Lanas A, Blandizzi C, Lems WF, Hermann M, Hunt RH; International NSAID Consensus Group. Safe prescribing of non-steroidal anti-inflammatory drugs in patients with osteoarthritis-an expert consensus addressing benefits as well as gastrointestinal and cardiovascular risks. BMC Med. 2015 Mar;13:55. doi: 10.1186/s12916-015-0285-0288. PMID: 25857826
  24. Christiansen BA, Bhatti S, Goudarzi R, Emami S. Management of osteoarthritis with avocado/soybean unsaponifiables. Cartilage. 2015 Jan;6(1):30-44. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4303902/. PMID: 25621100
  25. Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain - United States, 2016. MMWR Recomm Rep. 2016 Mar;65(1):1-49. doi: 10.15585/mmwr.rr6501e1. Accessed 21 Jun 2016. PMID: 26987082
  26. Altman R, Alarcon G, Appelrouth D, et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum. 1991 May;34(5):505-514. PMID: 2025304
  27. Altman R, Alarcon G, Appelrouth D, et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis Rheum. 1990 Nov;33(11):1601-1610. Accessed 26 Sep 2018. PMID: 2242058
  28. Altman R, Asch E, Bloch D, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Arthritis Rheum. 1986 Aug;29(8):1039-1049. PMID: 3741515
  29. Deveza, LA. Overview of the management of osteoarthritis. UpToDate. http://www.uptodate.com. 11 Oct 2017.
  30. Deveza LA, Bennell K. Management of knee osteoarthritis. UpToDate. http://www.uptodate.com. 11 Jun 2018.
  31. Block JA, Scanzello C. Osteoarthritis. In: Goldmann L, Schafer AI, eds. Goldman-Cecil Medicine. 25th . Philadelphia, PA: Elsevier; 2016.
  32. Doherty M, Abhishek A. Clinical manifestations and diagnosis of osteoarthritis. UpToDate. http://www.uptodate.com. 30 Oct 2017.
  33. Geenen R, Overman CL, Christensen R, et al. EULAR recommendations for the health professional’s approach to pain management in inflammatory arthritis and osteoarthritis. Ann Rheum Dis. 2018 Jun;77(6):797-807. doi: 10.1136/annrheumdis-2017-212662. PMID: 29724726
  34. Kalunian KC. Risk factors for and possible causes of osteoarthritis. UpToDate. http://www.uptodate.com. 06 Oct 2017.
  35. Ministry of Health, Malaysia. Clinical practice Guidelines. Management of Osteoarthritis. http://www.moh.gov.my. 2013.
  36. National Health and Medical Research Council. Guideline for the management of knee and hip osteoarthritis. Australia: The Royal Australian College of General Practitioners. http://www.nhrmc.gov.au. Jul 2018.
  37. Sinusas, K. Osteoarthritis: diagnosis and treatment. Am Fam Physician. 2012 Jan;85(1):49-56. PMID: 22230308
  38. Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Care Res. 2020 Feb;72(2):149-162. doi: 10.1002/acr.24131. PMID: 31908149
  39. Bruyère O, Honvo G, Veronese N, et al. An updated algorithm recommendation for the management of knee osteoarthritis from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Semin Arthritis Rheum. 2019 Dec;49(3):337-350. doi: 10.1016/j.semarthrit.2019.04.008. PMID: 31126594
  40. National Institute for Health and Care Excellence (NICE). Management of osteoarthritis. NICE. https://pathways.nice.org.uk. 15 Oct 2019.
  41. Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019 Nov;27(11):1578-1589. doi: 10.1016/j.joca.2019.06.011. PMID: 31278997
  42. The Non-surgical Management of Hip & Knee Osteoarthritis Work Group; US Department of Veterans Affairs; US Department of Defense. VA/DoD clinical practice guideline for the non-surgical management of hip & knee osteoarthritis. US Department of Defense. https://www.healthquality.va.gov/. Jun 2020.
  43. Kloppenburg M, Kroon FPB, Blanco FJ, et al. 2018 update of the EULAR recommendations for the management of hand osteoarthritis. Am Rheum Dis. 2019 Jan;78(1):16-24. doi: 10.1136/annrheumdis-2018-213826. PMID: 30154087
  44. Kloppenburg M, Kroon F. Management of hand osteoarthritis. UpToDate. https://www.uptodate.com. 18 Jun 2021.
  45. Martel-Pelletier J, Maheu E, Pelletier JP, et al. A new decision tree for diagnosis of osteoarthritis in primary care: international consensus of experts. Aging Clin Exp Res. 2019 Jan;31(1):19-30. doi: 10.1007/s40520-018-1077-8. PMID: 30539541
  46. National Institute for Health and Care Excellence (NICE). Osteoarthritis: care and management. NICE. https://www.nice.org.uk. 11 Dec 2020. Accessed 22 Aug 2021.
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