Bad knees: Experts don't recommend some common therapies

2:59 PM, December 12, 2008

Osteoarthritis of the knee is a common condition that eventually leads a lot of people to knee replacement surgery. But does anything short of this drastic surgery help?
New recommendations from the American Academy of Orthopaedic Surgeons advise people to lose weight, begin exercising and take acetaminophen or non-steroidal anti-inflammatory drugs (as well as intra-articular corticosteroids for short-term pain relief).

The guidelines, titled "Treatment of Osteoporosis of the Knee" advises against such common remedies as: arthroscopic lavage -- or washing out the joint; glucosamine and/or chondroitin sulfate or hydrochloride; needle lavage or custom-made foot orthotics.

Arthroscopic lavage is not recommended when the patient's only symptom is osteoarthritis. The procedure may be helpful in patients with other problems such as loose bodies in the knee or meniscus tears. "The current science shows us that just washing out the joint does not decrease the patient's osteoarthritis symptoms and can expose the patient to additional risk," said Dr. John Richmond, chairman of the AAOS work group, in a news release.

What may be most helpful for people whose body mass index is greater than 25 is to lose a minimum of 5% of their body weight and begin or increase participation in low-impact aerobic exercise. "As far as losing weight, this has the highest potential to actually slow the progression of the disease," Richmond said.

The committee was not able to recommend for or against bracing, acupuncture or intra-articular hyaluronic acid because not enough scientific evidence exists on those therapies.
A copy of the guidelines can be found on the AAOS website.

- Shari Roan