Management of moderate to severe knee osteoarthritis

NSAID: nonsteroidal anti-inflammatory drug; OA: osteoarthritis.

* Patients with moderate to severe knee OA have persistent pain, which significantly impairs functionality, activity participation, and quality of life.

¶ If the patient has OA limited to the knees and hands, a trial of topical NSAIDs is reasonable before advancing to oral NSAIDs (if not otherwise contraindicated).

Δ Assess the need for a proton pump inhibitor if increased risk for gastrointestinal side effects.

◊ Intra-articular glucocorticoid injections are not routinely recommended, because the pain relief is mild to moderate and is short lived. Refer to UpToDate content on management of knee OA.

§ Refer to UpToDate content on management of knee OA for adjunctive measures.