Non-surgical Treatment Recommendations for Knee Osteoarthritis

Purpose of Review Osteoarthritis (OA) of the knee is a common disease with associated direct and indirect costs having a significant societal impact. This review is conducted to discuss various treatment options for knee OA, highlight the most recent evidence regarding efficacy, and devise clinical recommendations to meet the needs of the patients. Recent Findings Pharmacologically, options tend to be limited. Simple analgesics such as acetaminophen and nonsteroidal anti-inflammatory drugs are widely used, with efficacy and safety being questioned. Mild opioids can be considered, although strong opioids are discouraged and need to be incorporated with great caution. Therapeutic exercises and weight loss have been the cornerstone of knee OA management. Symptomatic relief can be achieved with intra-articular steroids, hyaluronic acid, and orthobiologics injections as well. More recently, genicular nerve neurotomy has been introduced to the treatment algorithm and shown promising results, although some refinement of the technique is likely needed in the future. Summary A proper and astute approach is adopting a comprehensive treatment program encompassing multimodal and multidisciplinary modalities. Future direction should focus on the clinical success of such effort in terms of pain and function improvement, patient satisfaction, and reduction in a financial burden to the health care system.