Current Treatment Options for Osteoarthritis of the Knee
CURRENT OSTEOARTHRITIS TREATMENTS
For patients who have been diagnosed with osteoarthritis (OA), their physician will determine the best way to treat their condition based on its severity, the pain associated with it, and their lifestyle limitations due to OA.
While there is no cure for OA, there are a number of treatment options that can be explored depending on osteoarthritis severity.
- Lifestyle: weight loss, exercise, protecting your knees from excess stress, physical therapy
- Analgesics: simple pain relievers, such as acetaminophen
- NSAIDS (non-steroidal anti-inflammatory drugs), such as ibuprofen or aspirin
- Steroids, also called corticosteroids
- Viscosupplements: hyaluronic acid (HA), also called sodium hyaluronate or hyaluronan
- Opioids: powerful pain relievers, such as morphine
- Surgery, such as total knee replacement
When conservative approaches to treating knee pain due to osteoarthritis, such as physical therapy, weight loss, exercise, or pain relievers are no longer effective, alternative non-surgical treatment options may be beneficial, such as steroids or viscosupplements.
STEROIDS
Corticosteroid injections have been used for over 45 years for their potent anti-inflammatory effects which can reduce pain quickly. While steroids provide rapid pain relief, the effects are typically short lived.7,8 In addition, they may cause additional joint damage or even severe joint destruction if given repeatedly over a long period of time.9
VISCOSUPPLEMENTS
Viscosupplements have been used globally for more than 25 years to reduce pain associated with osteoarthritis by improving the viscosity and function of the synovial fluid in the joint. While injections of HA alone can provide up to six months of pain relief, the patient does not typically experience the peak effects until 8 weeks after the final injection.10
Only Cingal® works by combining a fast acting steroid with a long lasting viscosupplement to deliver rapid pain relief proven to last through six months.11
*In patients with early to moderate osteoarthritis. Patient experience may vary.
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5. Muscle Impairments in Patients With Knee Osteoarthritis Alnahdi et al
6. Tuhina Neogi, The Epidemiology and Impact of Pain in Osteoarthritis. Osteoarthritis Cartilage. Author manuscript; available in PMC 2014 September 01.
7. Bellamy N, Campbell J, Robinson V, et al. Intraarticular corticosteroid for treatment of osteoarthritis of the knee. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD005328.
8. Ozturk C, Atamaz F, Hepguler S, et al. The safety and efficacy of Intra-articular hyaluronan with/without corticosteroid in knee osteoarthritis: 1-year, single-blind, randomized study. Rheumatol Int. 2006 Feb;26(4):314-9.
9. Triamcinolone hexacetonide 20 mg/ml suspension for injection. Intrapharm Laboratories Limited. May 2016. Web: https://www.medicines.org.uk/emc/medicine/28913
10. Bannuru R, Natov N, Dasi U, et al. Therapeutic trajectory following intra-articular hyaluronic acid injection in knee osteoarthritis – meta-analysis. Osteoarthritis and Cartilage 19 (2011) 611-619.
11. Hangody L, Szody R, Lukasik P, et al. Intraarticular injection of a cross-linked sodium hyaluronate combined with triamcinolone hexacetonide (Cingal) to provide symptomatic relief of osteoarthritis of the knee: a randomized; double-blind; place-controlled multicenter clinical trial [published online ahead of print May 1, 2017]. Cartilage. doi: 10.1177/1947603517703732
12. Daley, M. Clinical Efficacy and Safety of MONOVISC™: A lightly cross-linked highly concentrated hyaluronan specially formulated for single injection in osteoarthritis.(2013) 2.
13. Anika data on file