If surgery for your knee arthritis scares you, here’s a ranking by effectiveness of conservative treatments for osteoarthritis in the knee joint – in which the shock-absorbing cartilage between the bones wears down.
This wearing down results in bone-on-bone contact for many men and women, and the pain can be quite severe.
Surgery always carries risks, especially for people with other medical problems such as heart failure, kidney disease and diabetes.
Most Effective Conservative Treatment for Osteoarthritis of the Knee
Of all the possible treatments, it is naproxen, an over-the-counter painkiller, says a report in the Journal of the American Academy of Orthopaedic Surgeons (May 1, 2018).
Not only does this drug work well with pain reduction, but it also improves knee function and is relatively safe and affordable.
However, there were other types of treatment to be considered, for which naproxen did not rank No. 1.
“This is the first comprehensive mixed-comparison analysis comparing best-evidence scientific research and excluding lower quality studies that can bias the outcomes,” explains lead study author David Jevsevar, MD, an orthopedic surgeon, in the report.
“Using a statistical ranking technique, we worked to provide evidence regarding which of the most common NSAIDs are most likely to decrease pain and improve function,” continues Dr. Jevsevar in the paper, “and we attempted to fill in the gaps in evidence for more inconclusive treatments such as HA, PRP, and corticosteroids.”
Effectiveness Ranking for Conservative Knee Osteoarthritis Treatment
Short-term pain relief. Cortisone injections won over naproxen. In fact, here’s the ranking in descending order for short-term relief of pain from knee osteoarthritis:
• Cortisone shots
• Ibuprofen
• PRP injections
• Naproxen
• Celebrex
Functional improvement
• Naproxen
• Voltaren
• Celebrex
• Ibuprofen
• PRP injections
Functional improvement WITH pain reduction
• Naproxen
• Cortisone injections
• PRP injections
• Ibuprofen
• Celebrex
So where is HA (hyaluronic acid) in these effectiveness rankings? The study found that HA is not much better than placebo.
Other Conservative Treatments Shown by Previous Studies
The following can benefit patients (no particular order):
• Strength training
• Low impact aerobics
• Weight loss in those with a body mass index over 25
Water aerobics can also provide some benefit, allowing the patient to exercise without the worry of impact motions on the joint.
The JAAOS study analyzed the data from numerous trials, and patients are encouraged to use these results as guidelines for their nonsurgical treatment of knee osteoarthritis.
