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Guideline for the management of knee and hip osteoarthritis

Summary of recommendations

Conditional recommendations against the intervention

Cold therapy – Knee and/or hipv

Recommendation

We suggest not offering local cold application (eg ice packs) for people with knee and/or hip OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Very low

Valgus unloading/ realignment knee braces for medial tibiofemoral compartment and realigning patellofemoral braces for patellofemoral OA

Recommendation

We suggest not offering valgus unloading/realignment braces for people with medial tibiofemoral compartment knee OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Low

Recommendation

We suggest not offering realigning patellofemoral braces for patellofemoral OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Very low

Shoe orthotics (lateral wedge insoles) – Knee

Recommendation

We suggest not offering lateral wedge insoles for people with medial tibiofemoral knee OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Very low

Footwear – Knee

Recommendation

We suggest not offering unloading shoes, minimalist footwear or rocker-sole shoes for people with symptomatic knee OA

However, clinicians may consider advising people with OA to wear footwear with shock-absorbing properties and avoid high-heeled shoes

Strength of recommendation

Conditional against recommendation

Quality of evidence

Very low (unloading shoes, minimalist footwear)
Low (rocker-sole shoes

Kinesio taping – Knee and hip

Recommendation

We suggest not offering kinesio taping for people with knee and/or hip OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Very low

Other electrotherapy – Knee and/or hip (eg shockwave, interferential, laser

Recommendation

We suggest not offering electrotherapy modalities of shockwave, interferential or laser for people with knee and/or hip OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Low (laser)
Very low (shockwave, interferential, laser-hip)

Therapeutic ultrasound – Knee and/or hip

Recommendation

We suggest not offering therapeutic ultrasound for people with knee and/or hip OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Moderate (knee)
Low (hip)

Acupuncture – Knee and/or hip

Recommendation

We suggest not offering acupuncture (ie traditional, laser, electrical) for people with knee and/or hip OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Low (knee)
Very low (hip)

Topical capsaicin – Knee

Recommendation

We suggest not offering topical capsaicin for people with knee OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Low

Bisphosphonates – Knee and/or hip

Recommendation

We suggest not offering bisphosphonates for people with knee and/or hip OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Very low

Calcitonin – Knee and/or hip

Recommendation

We suggest not offering calcitonin for people with knee and/or hip OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Very low

Anti-NGF – Knee and/or hip

Recommendation

We suggest not offering NGF for people with knee and/or hip OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Moderate

Colchicine – Knee and/or hip

Recommendation

We suggest not offering colchicine for people with knee and/or hip OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Very low

Methotrexate – Knee and/or hip

Recommendation

We suggest not offering methotrexate for people with knee and/or hip OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Low

Viscosupplementation – Knee

Recommendation

We suggest not offering viscosupplementation injection for people with knee OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Low

Dextrose prolotherapy – Knee and/or hip

Recommendation

We suggest not offering dextrose prolotherapy for people with knee and/or hip OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Low

Glucosamine – Knee and/or hip

Recommendation

We suggest not offering glucosamine for people with knee and/or hip OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Very low (knee)
Low (hip)

Chondroitin – Knee and/or hip

Recommendation

We suggest not offering chondroitin for people with knee and/or hip OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Very low

Glucosamine and chondroitin in compound form – Knee and/or hip

Recommendation

We suggest not offering glucosamine and chondroitin in compound form for people with knee and/or hip OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Very low

Vitamin D – Knee and/or hip

Recommendation

We suggest not offering vitamin D for people with knee and/or hip OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Low (knee)
Very low (hip)

Omega-3 fatty acids – Knee and/or hip

Recommendation

We suggest not offering omega-3 fatty acids for people with knee and/or hip OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Very low

Diacerein – Knee and/or hip

Recommendation

We suggest not offering diacerein for people with knee and/or hip OA

Strength of recommendation

Conditional against recommendation

Quality of evidence

Very low

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