AAOS clinical practice guideline: treatment of osteoarthritis of the knee: evidence-based guideline, 2nd edition.

TLDR: The aging of the baby boomers, the rise in rates of obesity, and a greater emphasis on staying active suggest that the emotional and physical impact of knee osteoarthritis will become more significant.

Abstract: Osteoarthritis results from an imbalance between the breakdown and repair of articular cartilage in any joint and occurs as a result of multiple risk factors, including trauma, overuse, and genetic predisposition. Osteoarthritis (of any joint) was the primary diagnosis that led to 11.3 million ambulatory care visits in 2009. The Centers for Disease Control report that one in two individuals may develop symptoms of osteoarthritis in at least one knee by age 85 years. The annual incidence of knee osteoarthritis in the United States is estimated at 240 persons per 100,000. Prevalence of the condition increases with age, especially in women. In adults >50 years of age, the incident risk in women is estimated to be 45% higher than that in men. Genetics, obesity, certain occupations, repetitive knee bending, and heavy lifting are other factors that increase an individual’s risk of developing the disease. Older adults with self-reported osteoarthritis visit their physicians more frequently and experience greater functional limitations than do others in the same age group. The aging of the baby boomers, the rise in rates of obesity, and a greater emphasis on staying active suggest that the emotional and physical impact of knee osteoarthritis will become more significant. Persons with knee osteoarthritis report joint pain, stiffness, and difficulty with mobility. The aim of treatment is to provide symptomatic pain relief, improve knee function, and improve a patient’s quality of life. Most interventions are associated with some risk, especially if the treatment is invasive and/or surgical. Treatment contraindications vary based on patient factors and comorbidities. Individual management options should be reviewed through a shared-decision approach to assess the efficacy, benefits, and risks of specific treatments. The American Academy of Orthopaedic Surgeons Clinical Practice Guideline Treatment of Osteoarthritis of the Knee: Evidence-Based Guideline, 2nd Edition, summarizes the medical evidence of treatment efficacy when managing patients with knee osteoarthritis.