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2015 ; 38
(4
): 115-9
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English Wikipedia
Managing osteoarthritis
#MMPMID26648637
Yu SP
; Hunter DJ
Aust Prescr
2015[Aug]; 38
(4
): 115-9
PMID26648637
show ga
Management of osteoarthritis should be based on a combination of non-drug and
drug treatments targeted towards prevention, modifying risk and disease
progression. Obesity is the most important modifiable risk factor, so losing
weight in addition to land- and water-based exercise and strength training is
important. While paracetamol can be tried, guidelines recommend non-steroidal
anti-inflammatory drugs as first-line treatment for osteoarthritis. If there are
concerns about the adverse effects of oral treatment, particularly in older
patients or those with comorbidities, topical non-steroidal anti-inflammatory
drugs can be used. Glucosamine does not appear to be any better than placebo for
pain. Its effect on the structural progression of disease when taken alone or in
combination with chondroitin is uncertain. Fish oil has not been found to reduce
the structural progression of knee arthritis. Surgical interventions should be
avoided in the first instance, with arthroscopic procedures not showing benefit
over sham procedures or optimised physical and medical therapy. Joint replacement
surgery should be considered for severe osteoarthritis.