Knee Osteoarthritis Clinical Practice Guidelines (AAOS, 2021)

American Academy of Orthopaedic Surgeons

These are some of the highlights of the guidelines without analysis or commentary. For more information, go directly to the guidelines by clicking the link in the reference.

November 02, 2021

Clinical practice guidelines on knee osteoarthritis (nonarthroplasty) were published in August 2021 by the American Academy of Orthopaedic Surgeons (AAOS).[1,2]

The use of lateral wedge insoles is not recommended for patients with osteoarthritis of the knee.

The use of canes may improve function and pain in patients with osteoarthritis of the knee.

The use of braces as treatment may improve pain, function, and quality of life in patients with osteoarthritis of the knee.

Unless contraindicated, topical application of nonsteroidal anti-inflammatory drugs (NSAIDs) should be used to improve function and quality of life in patients with knee osteoarthritis.

Exercise routines (ie, supervised, unsupervised, and/or aquatic) are recommended versus no exercise for improving pain and function in patients with knee osteoarthritis.

Balance, agility, and coordination programs (ie, neuromuscular training) can be used in combination with traditional exercise regimens to improve walking speed and performance-based function.

Education programs on self-management and general education of the condition are recommended to improve pain and function for patients with osteoarthritis of the knee.

In knee osteoarthritis patients who are overweight or obese, sustained weight loss is recommended as a measure to improve pain and function.

Unless contraindicated, oral administration of NSAIDs or acetaminophen is recommended to improve function and pain in patients with osteoarthritis of the knee.

Not recommended is the use of oral narcotics (including tramadol), as they are not effective at improving pain or function and their use results in a significant increased risk of adverse events.

Also not recommended for routine use in symptomatic knee osteoarthritis is intra-articular injection(s) of hyaluronic acid.

Intra-articular injections of corticosteroids may provide some short-term relief for symptomatic knee osteoarthritis.

For more information, please go to Osteoarthritis.

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