DOI: https://doi.org/10.22141/1608-1706.4.20.2019.178743

Management of patients with knee osteoarthritis in accordance with the recommendations of the modern medical societies: focus on ESCEO 2019

I.Yu. Golovach, Ye.D. Yehudina, S.Kh. Ter-Vartanian

Abstract


Osteoarthritis (OA) is the most common form of arthritis, characterized by articular cartilage destruction, synovial membrane inflammation and subchondral bone remodeling. Knee OA is the most common location of OA, widespread among people over 50, affecting more than 250 million people worldwide. Besides, OA is a major cause of pain in older people, pain in the hip and knee leads to disability and an increased risk of all-cause mortality. The goals of OA treatment are to reduce symptoms and slow the disease progression, which, in turn, may reduce the impact of OA on the patient’s quality of life, with a consequent reduction in the need for health care resources. Currently, various academic and professional societies have developed various guidelines for the standardization of patient’s management and recommended available treatment options. Low-impact physical activity is supported by all modern medical societies while prescribing other interventions and medications has conflicting recommendations in different communities. The latest 2019 updated recommendations for the patient treatment with knee osteoarthritis are presented by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Disorders (ESCEO), which includes 15 treatment recommendations and an updated stepwise algorithm for managing a patient with knee OA, provides practical guidance for the clinicians in the light of the latest data on the efficacy and safety of drugs. The ESCEO algorithm underlines the continued importance of non-pharmacological interventions throughout the course of OA treatment. This article discusses the benefits and limitations of various non-pharmacological, pharmacological and surgical methods for treating OA, with a special focus on safety.

Keywords


knee osteoarthritis; algorithm; recommendations; non-drug treatment; drug treatment; exercise; glucosamine sulfate; chondroitin sulfate; diacerein; combination of avocado and soybean oil

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