Table 2 Recommended therapies or modalities considered in four comprehensive treatment guidelines for lower-limb osteoarthritis published within the past 5 yearsa
From: A critical appraisal of clinical practice guidelines for the treatment of lower-limb osteoarthritis
| Â | Guideline [reference] | |||
|---|---|---|---|---|
| Â | Â | EULAR [6] (Strength of | Â | |
Therapy/modality | (Grade of evidenceb) | recommendationc) | ||
Acetaminophen | Recommended (A) | Recommended | Recommended (A) | Recommended |
| Â | Â | Â | Â | (mild to moderate OA) |
NSAIDs | Recommended (A) | Recommended | Recommended (A) | Recommended |
| Â | Â | Â | Â | (moderate to severe OA) |
Cox-2-specific NSAIDs | Not discussed | Recommended | Not discussed | Recommended |
| Â | Â | (2nd-line therapy) | Â | (2nd-line therapy in patient |
| Â | Â | Â | Â | with high gastrointestinal risk) |
Corticosteroid joint injection | Recommended (A) | Recommended | Recommended (A) | Recommended |
Hyaluronic acid joint injection | Recommended (A) | Recommended | Recommended (B) | Recommended |
Capsaicin cream | Recommended (A) | Recommended | Recommended (A) | Recommended |
Other topical cream | Not discussed | Recommended | Recommended (A) | Recommended |
(e.g. NSAID cream) | Â | Â | Â | Â |
Opioid analgesics | Recommended (B) | Recommended | Recommended (B) | Recommended |
Aerobic exercise | Recommended (A) | Recommended | Recommended (A) | Recommended |
Strengthening and | Recommended (B) | Recommended | Recommended (A) | Recommended |
range-of-motion exercise | Â | Â | Â | Â |
Education | Recommended (no grade) | Recommended | Recommended (A) | Recommended |
Arthritis self-management | Recommended (A) | Recommended | Recommended (A) | Recommended |
education | Â | Â | Â | Â |
Physical therapy | Recommended (no grade) | Recommended | Recommended | Recommended |
Occupational therapy | Recommended (C) | Recommended | Recommended | Recommended |
Telephone contact | Recommended (A) | Recommended | Recommended (B) | Recommended |
Weight loss | Recommended (B) | Recommended | Recommended (B) | Recommended |
Walking assistive devices | Recommended (C) | Recommended | Recommended (B) | Recommended |
(e.g. shoe inserts, cane) | Â | Â | Â | Â |
Assistive devices for | Recommended (C) | Recommended | Not discussed | Recommended |
activities of daily living | Â | Â | Â | Â |
Glucosamine (with or | Not discussed | Recommended | Recommended (A) | Not recommended |
without chondroitin) | Â | Â | Â | Â |
Knee brace or taping | Not discussed | Not discussed | Recommended (B) | Recommended |
Hot pack or ice pack | Recommended (no grade) | Recommended | Not discussed | Recommended |
Joint protection techniques | Recommended (no grade) | Recommended | Recommended (A) | Recommended |
Planning activities | Recommended (no grade) | Recommended | Recommended (A) | Recommended |
Acupuncture | Not discussed | Recommended | Not discussed | Not recommended |
Electrical stimulation (e.g. TENS) | Not discussed | Recommended | Not discussed | Not discussed |
Massage | Not discussed | Recommended | Not discussed | Not discussed |