Therapeutic Options in Osteoarthritis of the Hip or Knee

  • Martijn Gerritsen
  • Ramon E. Voorneman
  • Joost DekkerEmail author
  • Willem F. Lems
Part of the SpringerBriefs in Specialty Topics in Behavioral Medicine book series (BRIEFSSPETOBEME)


This chapter summarizes therapeutic options in osteoarthritis of the knee or hip. Treatment options include nonpharmacological, pharmacological, and surgical interventions.


Total Knee Arthroplasty Nerve Growth Factor Hyaluronic Acid High Tibial Osteotomy Strontium Ranelate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Sharma L et al (2006) Epidemiology of osteoarthritis: an update. Curr Opin Rheumatol 18:147–156PubMedCrossRefGoogle Scholar
  2. 2.
    Zhang W et al (2008) OARSI recommendations for the management of hip and knee osteoarthritis, part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage 16:137–162PubMedCrossRefGoogle Scholar
  3. 3.
    Zhang W et al (2010) OARSI recommendations for the management of hip and knee osteoarthritis, part III: changes in evidence following systematic cumulative update of research published through January 2009 Osteoarthritis Cartilage 18:476–499PubMedCrossRefGoogle Scholar
  4. 4.
    Nederlandse Orthopedische Vereniging (2007) Richtlijn Diagnostiek en behandeling van heup en Knie Artrose. CBO, UtrechtGoogle Scholar
  5. 5.
    Felson DT et al (1988) Obesity and knee osteoarthritis: the Framingham study. Ann Intern Med 109:18–24PubMedCrossRefGoogle Scholar
  6. 6.
    Lievense AM et al (2002) Influence of obesity on the development of osteoarthritis of the hip: a systematic review. Rheumatology 41:1155–1162PubMedCrossRefGoogle Scholar
  7. 7.
    Christensen R et al (2005) Weight loss: the treatment of choice for knee osteoarthritis? A randomized trial. Osteoarthritis Cartilage 13:20–27PubMedCrossRefGoogle Scholar
  8. 8.
    Messier SP et al (2004) Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the arthritis, diet, and activity promotion trial. Arthritis Rheum 50:1501–1510PubMedCrossRefGoogle Scholar
  9. 9.
    Richette PJ et al (2011) Beneficial effects of massive weight loss on symptoms, joint biomarkers and systemic inflammation in obese patients with knee OA. Ann Rheum Dis 70:139–144PubMedCrossRefGoogle Scholar
  10. 10.
    Christensen R et al (2007) Effect of weight reduction in obese patients diagnosed with knee osteoarthritis: a systematic review and meta-analysis. Ann Rheum Dis 66:433–439PubMedCrossRefGoogle Scholar
  11. 11.
    Fransen M, Mc Connell S (2008) Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev 4:CD004376PubMedGoogle Scholar
  12. 12.
    Jamvedt G et al (2008) Physical therapy interventions for patients with osteoarthritis of the knee: an overview of systematic reviews. Phys Ther 88:123–136CrossRefGoogle Scholar
  13. 13.
    Fransen M et al (2010) Does land-based exercise reduce pain and disability associated with hip osteoarthritis ? A meta-analysis of randomized controlled trials. Osteoarthritis Cartilage 18:613–620PubMedCrossRefGoogle Scholar
  14. 14.
    Pisters MF et al (2007) Long-term effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: a systematic review. Arthritis Rheum 57:1245–1253PubMedCrossRefGoogle Scholar
  15. 15.
    Sharma L et al (2001) The role of knee alignment in disease progression and functional decline in knee osteoarthritis. JAMA 286:188–195PubMedCrossRefGoogle Scholar
  16. 16.
    Brouwer RW et al (2005) Braces and orthoses for treating osteoarthritis of the knee. Cochrane Database Syst Rev 25(1):CD004020Google Scholar
  17. 17.
    Kirkley A et al (1999) The effect of bracing on varus gonarthrosis. J Bone Joint Surg Am 81:539–548PubMedGoogle Scholar
  18. 18.
    Arnold CM, Faulkner RA (2007) The history of falls and the association of the timed up and go test to falls and near falls in older adults with hip osteoarthritis. BMC Geriatr 7:17PubMedCrossRefGoogle Scholar
  19. 19.
    Jones A et al (2012) Impact of cane use, function, general health and energy expenditure during gait in patients with knee osteoarthritis: a randomised controlled trial. Ann Rheum Dis 71:172–179PubMedCrossRefGoogle Scholar
  20. 20.
    McCarthy CJ et al (2006) Pulsed electromagnetic energy treatment offers no clinical benefit in reducing the pain of knee osteoarthritis: a systematic review. BMC Musculoskelet Disord 15:7–51Google Scholar
  21. 21.
    Bjordal JM et al (2007) Short-term efficacy of physical interventions in osteoarthritic knee pain. A systematic review and meta-analysis of randomised placebo-controlled trials. BMC Musculoskelet Disord 8:51PubMedCrossRefGoogle Scholar
  22. 22.
    Manheimer E et al (2007) Meta-analysis: acupuncture for osteoarthritis of the knee. Ann Intern Med 146:868–877PubMedCrossRefGoogle Scholar
  23. 23.
    Bjordal JM et al (2004) Non-steroidal anti-inflammatory drugs including cyclo-oxygenase-2 inhibitors, in osteo-arthritic knee pain: meta-analysis of placebo controlled trails. BMJ 329:1317–1320PubMedCrossRefGoogle Scholar
  24. 24.
    Towheed TE et al (2006) Acetaminophen for osteoarthritis. Cochrane Database Syst Rev 1:CD004257PubMedGoogle Scholar
  25. 25.
    Hooper L et al (2004) The effectiveness of five strategies for the prevention of gastrointestinal toxicity induced by non-steroidal anti-inflammatory drugs: systematic review. BMJ 329:948–952PubMedCrossRefGoogle Scholar
  26. 26.
    Kearney PM et al (2006) Do selective cyclo-oxygenase inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis ? Meta-analysis of randomised trials. BMJ 332:1302–1308PubMedCrossRefGoogle Scholar
  27. 27.
    Schjerning Olsen AM et al (2011) Duration of treatment with nonsteroidal anti-inflammatory drugs and impact on risk of death and recurrent myocardial infarction in patients with prior myocardial infarction: a nationwide cohort study. Circulation 123:2226–2235PubMedCrossRefGoogle Scholar
  28. 28.
    Opinion of the committee for medicinal products for human use pursuant to article 5(3) of regulation (EC) No 726/2004, for nonselective non steroidal anti-inflammatory drugs (NSAIDs)Google Scholar
  29. 29.
    Lin J et al (2005) Efficacy of topical NSAIDs in the treatment of osteoarthritis: a meta-analysis of randomized controlled trials. Chin J Evid Based Med 5(9):667–674Google Scholar
  30. 30.
    Avouac J et al (2007) Efficacy and safety of opioids for osteoarthritis: a meta-analysis of randomized controlled trials. Osteoarthritis Cartilage 15:957–965PubMedCrossRefGoogle Scholar
  31. 31.
    Nüesch E et al (2009) Oral or transdermal opioids for osteoarthritis of the knee or hip. Cochrane Database Syst Rev 4:CD003115PubMedGoogle Scholar
  32. 32.
    Sawitzke AD et al (2010) Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT. Ann Rheum Dis 69:1459–1464PubMedCrossRefGoogle Scholar
  33. 33.
    Wandel S et al (2010) Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis. BMJ 341:c4675PubMedCrossRefGoogle Scholar
  34. 34.
    Reginster JY et al (2001) Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet 357(9252):251–256PubMedCrossRefGoogle Scholar
  35. 35.
    Hochberg MC (2010) Structure-modifying effects of chondroitin sulphate in knee osteoarthritis. An updated meta-analysis of randomized placebo-controlled trials of 2-year duration. Ostoarthritis Cartilage 18(suppl 1):S28–S31CrossRefGoogle Scholar
  36. 36.
    Kahan A et al (2009) Long-term effects of chondroitins 4 and 6 sulfate on knee osteoarthritis: the study on osteoarthritis progression prevention, a two-year, randomized, double-blind, placebo-controlled trial. Arthritis Rheum 60:524–533PubMedCrossRefGoogle Scholar
  37. 37.
    Bingham CO 3rd et al (2006) Risedronate decreases biochemical markers of cartilage degradation but does not decrease symptoms or slow radiographic progression in patients with medial compartment osteoarthritis of the knee: results of the two-year multinational knee osteoarthritis structural arthritis study. Arthritis Rheum 54(11):3494–3507PubMedCrossRefGoogle Scholar
  38. 38.
    Neogi T et al (2008) The effect of alendronate on progression of spinal osteophytes and disc space narrowing. Ann Rheum Dis 67(10):1427–1430PubMedCrossRefGoogle Scholar
  39. 39.
    Bruyere O et al (2008) Effects of strontium ranelate on spinal osteoarthritis progression. Ann Rheum Dis 67:335–339PubMedCrossRefGoogle Scholar
  40. 40.
    Reginster J-Y, Badurski J, Bellamy N et al (2013) Efficacy and safety of strontium ranelate in the treatment of knee osteoarthritis: results of a double-blind, randomised placebo-controlled trial. Ann Rheum Dis 72:179–186Google Scholar
  41. 41.
    Bellamy N, Campbell J, Robinson V, Gee T, Bourne R, Wells G (2006) Intra-articular corticosteroid for treatment of osteoarthritis of the knee. Cochrane Database Syst Rev 2:CD005328PubMedGoogle Scholar
  42. 42.
    Navarro-Sarabia F et al (2011) A 40-month multicentre, randomised placebo-controlled study to assess the efficacy and carry-over effect of repeated intra-articular injections of hyaluronic acid in knee osteoarthritis: the AMELIA project. Ann Rheum Dis 70(11):1957–1962PubMedCrossRefGoogle Scholar
  43. 43.
    Lane NE et al (2010) Tanezumab for the treatment of pain from osteoarthritis of the knee. N Eng J Med 363:1521–1531CrossRefGoogle Scholar
  44. 44.
    Wood JN (2010) Nerve growth factor and pain. N Eng J Med 363:1572–1573CrossRefGoogle Scholar
  45. 45.
    Ethgen O et al (2004) Quality of life in total hip and total knee arthroplasty: a qualitative and systematic review of the literature. J Bone Joint Surg Am 86:963–974PubMedGoogle Scholar
  46. 46.
    Zhang W et al (2007) OARSI recommendations for the management of hip and knee osteoarthritis, part I: critical appraisal of existing treatment guidelines and systematic review of current research evidence. Osteoarthritis Cartilage 15:981–1000PubMedCrossRefGoogle Scholar
  47. 47.
    Soderman P et al (2001) Outcome after total hip arthroplasty: part II. Disease-specific follow-up and the Swedish National Total Hip Arthroplasty Register. Acta Orthop Scand 72:113–119PubMedCrossRefGoogle Scholar
  48. 48.
    Rand JA et al (2003) Factors affecting the durability of primary total knee prostheses. J Bone Joint Surg Am 85:259–265PubMedGoogle Scholar
  49. 49.
    Katz JN (2006) Total joint replacement in osteoarthritis. Best Pract Res Clin Rheumatol 20:145–153PubMedCrossRefGoogle Scholar
  50. 50.
    Otten R et al (2010) [Trends in the number of knee and hip arthroplasties: considerable more knee and hip prostheses due to osteoarthritis in 2030]. Ned Tijdschr Geneeskd 154:A1534PubMedGoogle Scholar
  51. 51.
    Griffin T et al (2007) Unicompartmental knee arthroplasty for the treatment of unicompartmental osteoarthritis: a systematic study. ANZ J Surg 77:214–221PubMedCrossRefGoogle Scholar
  52. 52.
    Millis MB, Kim YJ (2002) Rationale for osteotomy and related procedures for hip preservation: a review. Clin Orthop Relat Res 405:108–121PubMedCrossRefGoogle Scholar
  53. 53.
    Virolainen P, Aro HT (2004) High tibial osteotomy for the treatment of osteoarthritis of the knee: a review of the literature and a meta-analysis of follow-up studies. Arch Orthop Trauma Surg 124:258–261PubMedCrossRefGoogle Scholar
  54. 54.
    Moseley JB et al (2002) A controlled trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med 347(2):81–88PubMedCrossRefGoogle Scholar

Copyright information

© The Author(s) 2014

Authors and Affiliations

  • Martijn Gerritsen
    • 1
  • Ramon E. Voorneman
    • 1
  • Joost Dekker
    • 2
    • 3
    Email author
  • Willem F. Lems
    • 4
  1. 1.Department of Rheumatology ∣ ReadeAmsterdamThe Netherlands
  2. 2.Department of Rehabilitation MedicineVU University Medical CenterAmsterdamThe Netherlands
  3. 3.Department of PsychiatryVU University Medical CenterAmsterdamThe Netherlands
  4. 4.Department of RheumatologyVU University Medical CenterAmsterdamThe Netherlands

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