Guideline for the management of knee and hip osteoarthritis

PICO questions for knee OA

PICO Questions

(patient/population/problem, intervention, comparison/control, outcome)

PICO questions are numbered in accordance with the relevant Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence tables in Appendix 5 of the Guideline for the management of knee and hip osteoarthritis: Technical document.



1.1. What are the benefits and harms of self-management education programs in the management of patients with knee osteoarthritis (OA)?

1.2. What are the benefits and harms of decision aids in the management of patients with knee OA? – excluded

1.3. What are the benefits and harms of cognitive behavioural therapy in the management of patients with knee OA?

1.4. What are the benefits and harms of all land-based exercise in the management of patients with knee OA?

1.5. Specific form of land-based exercise

1.5.1. What are the benefits and harms of muscle strengthening in the management of patients with knee OA?

1.5.2. What are the benefits and harms of walking in the management of patients with knee OA?

1.5.3. What are the benefits and harms of stationary cycling in the management of patients with knee OA?

1.5.4. What are the benefits and harms of Tai Chi in the management of patients with knee OA?

1.5.5. What are the benefits and harms of Hatha yoga in the management of patients with knee OA?

1.6. What are the benefits and harms of aquatic exercise/hydrotherapy in the management of patients with knee OA?

1.7. Manual therapy

1.7.1. What are the benefits and harms of massage in the management of patients with knee OA?

1.7.2. What are the benefits and harms of manipulation and mobilisation in the management of patients with knee OA?

1.8. What are the benefits and harms of weight management in the management of patients with knee OA?

1.9. Thermotherapy

1.9.1. What are the benefits and harms of local hot application in the management of patients with knee OA?

1.9.2. What are the benefits and harms of local cold application in the management of patients with knee OA?

1.10. Orthotic braces

1.10.1. What are the benefits and harms of varus unloading/re-alignment braces in the management of patients with knee OA?

1.10.2. What are the benefits and harms of valgus unloading/re-alignment braces in the management of patients with knee OA?

1.10.3. What are the benefits and harms of realigning patellofemoral braces in the management of patients with knee OA?

1.11. Insoles

1.11.1. What are the benefits and harms of medial wedged insoles in the management of patients with knee OA?

1.11.2. What are the benefits and harms of lateral wedge insoles in the management of patients with knee OA?

1.11.3. What are the benefits and harms of shock-absorbing insoles in the management of patients with knee OA?

1.11.4. What are the benefits and harms of arch supports in the management of patients with knee OA?

1.12. Shoes

1.12.1. What are the benefits and harms of unloading shoes in the management of patients with knee OA?

1.12.2. What are the benefits and harms of minimalist footwear in the management of patients with knee OA?

1.12.3. What are the benefits and harms of rocker-sole shoes in the management of patients with knee OA?

1.13. Taping

1.13.1. What are the benefits and harms of kinesio taping in the management of patients with knee OA?

1.13.2. What are the benefits and harms of patellar taping in the management of patients with knee OA?

1.14. What are the benefits and harms of walking cane/stick in the management of patients with knee OA?

1.15. Electromagnetic therapy

1.15.1. What are the benefits and harms of pulsed electromagnetic/shortwave therapy in the management of patients with knee OA?

1.15.2. What are the benefits and harms of shockwave therapy in the management of patients with knee OA?

1.16. Electrical stimulation

1.16.1. What are the benefits and harms of transcutaneous electrical nerve stimulation (TENS) in the management of patients with knee OA?

1.16.2. What are the benefits and harms of inferential currents in the management of patients with knee OA?

1.17. What are the benefits and harms of ultrasound in the management of patients with knee OA?

1.18. What are the benefits and harms of laser in the management of patients with knee OA?

1.19. Acupuncture

1.19.1. What are the benefits and harms of traditional acupuncture with manual stimulation in the management of patients with knee OA?

1.19.2. What are the benefits and harms of laser acupuncture in the management of patients with knee OA?

1.19.3. What are the benefits and harms of electroacupuncture in the management of patients with knee OA?

 


2.1. Oral analgesics

2.1.1. What are the benefits and harms of oral paracetamol in the management of patients with knee OA?

2.1.2. What are the benefits and harms of oral nonsteroidal anti-inflammatory drugs (NSAIDs) including cyclooxygenase-2 (COX-2) inhibitors in the management of patients with knee OA?

2.1.3. What are the benefits and harms of oral opioids in the management of patients with knee OA?

2.2. Topical analgesics

2.2.1. What are the benefits and harms of topical NSAIDs in the management of patients with knee OA?

2.2.2. What are the benefits and harms of transdermal opioids in the management of patients with knee OA?

2.2.3. What are the benefits and harms of topical capsaicin in the management of patients with knee OA?

2.3. Herbal therapies

2.3.1. What are the benefits and harms of avocado/soybean unsaponifiables (ASU) in the management of patients with knee OA?

2.3.2. What are the benefits and harms of Boswellia serrata in the management of patients with knee OA?

2.3.3. What are the benefits and harms of curcuma in the management of patients with knee OA?

2.3.4. What are the benefits and harms of pycnogenol in the management of patients with knee OA?

2.4. Nutraceuticals

2.4.1. What are the benefits and harms of glucosamine in the management of patients with knee OA?

2.4.2. What are the benefits and harms of chondroitin in the management of patients with knee OA?

2.4.3. What are the benefits and harms of glucosamine and chondroitin in compound form in the management of patients with knee OA?

2.4.4. What are the benefits and harms of vitamin D in the management of patients with knee OA?

2.4.5. What are the benefits and harms of (omega-3/6) poly-unsaturated fatty acids in the management of patients with knee OA?

2.4.6. What are the benefits and harms of collagen preparations in the management of patients with knee OA?

2.4.7. What are the benefits and harms of methylsulfonylmethane in the management of patients with knee OA?

2.4.8. What are the benefits and harms of diacerein in the management of patients with knee OA?

2.5. What are the benefits and harms of duloxetine in the management of patients with knee OA?

2.6. What are the benefits and harms of doxycycline in the management of patients with knee OA?

2.7. Anti-osteoporosis (anti-resorptive bone-acting) drugs

2.7.1. What are the benefits and harms of bisphosphonates in the management of patients with knee OA?

2.7.2. What are the benefits and harms of calcitonin in the management of patients with knee OA?

2.7.3. What are the benefits and harms of strontium ranelate in the management of patients with knee OA?

2.8. Investigational disease-modifying osteoarthritis drugs (DMOADs) (symptomatic or inflammatory modification)

2.8.1. What are the benefits and harms of interleukin-1 (IL-1) inhibitors in the management of patients with knee OA?

2.8.2. What are the benefits and harms of tumour necrosis factor alpha (TNF-alpha) inhibitors in the management of patients with knee OA?

2.8.3. What are the benefits and harms of anti-nerve growth factor (NGF) therapy in the management of patients with knee OA?

2.8.4. What are the benefits and harms of fibroblast growth factor (FGF) therapy in the management of patients with knee OA?

2.8.5. What are the benefits and harms of colchicine in the management of patients with knee OA?

2.8.6. What are the benefits and harms of methotrexate in the management of patients with knee OA?

2.8.7. What are the benefits and harms of statins in the management of patients with knee OA? – excluded

2.9. Intra-articular injections

2.9.1. What are the benefits and harms of corticosteroids in the management of patients with knee OA?

2.9.2. What are the benefits and harms of viscosupplementation in the management of patients with knee OA?

2.9.3. What are the benefits and harms of platelet-rich plasma (PRP) in the management of patients with knee OA?

2.9.4. What are the benefits and harms of stem cell therapy in the management of patients with knee OA?

2.9.5. What are the benefits and harms of dextrose prolotherapy in the management of patients with knee OA?


3.1. What are the benefits and harms of arthroscopic lavage and debridement interventions in the management of patients with knee OA?
3.2. What are the benefits and harms of arthroscopic meniscectomy interventions in the management of patients with knee OA?

3.3. What are the benefits and harms of arthroscopic procedures for cartilage repair interventions in the management of patients with knee OA?

 

4.1. What are the benefits and harms of combination weight management and exercise interventions compared to exercise in patients with knee OA?
4.2. What are the benefits and harms of combination weight management and exercise interventions compared to weight management in patients with knee OA?
4.3. What are the benefits and harms of combination exercise and cognitive behavioural interventions compared to exercise in patients with knee OA?
4.4. What are the benefits and harms of combination exercise and cognitive behavioural interventions compared to cognitive behavioural interventions in patients with knee OA?


 

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