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Guideline for the management of knee and hip osteoarthritis

Summary of recommendations

Conditional (neutral) recommendations for the intervention

Intervention: Self-management education programs – Knee and/or hip

Recommendation

We are unable to recommend either for or against formal face-to-face self-management education programs for people with knee and/or hip OA However, clinicians should provide information to enhance understanding about OA, its prognosis and its optimal management

Strength of recommendation

Conditional (neutral) recommendation

Quality of evidence

Very low

Intervention: Varus unloading knee braces for lateral tibiofemoral compartment knee OA

Recommendation

We are unable to recommend either for or against the use of varus unloading/realignment braces for people with lateral tibiofemoral compartment knee OA

Strength of recommendation

Conditional (neutral) recommendation (varus unloading/ realignment braces)

Quality of evidence

Very low (varus unloading/ realignment – no RCT data)

Intervention: Shoe orthotics (medial wedge insoles – Knee; shock-absorbing insoles and arch supports – knee and/or hip)

Recommendation

We are unable to recommend either for or against the use of medial wedged insoles for people with lateral tibiofemoral OA and valgus deformity

Strength of recommendation

Conditional (neutral) recommendation (medial wedged insoles)

Quality of evidence

Very low (medial wedged insoles) Very low (shockabsorbing insoles, arch support – no RCT data)

Recommendation

We are unable to recommend either for or against the use of shock-absorbing insoles or arch supports for knee and/or hip OA

Strength of recommendation

Conditional (neutral) recommendation (shock-absorbing insoles, arch support)

Quality of evidence

Very low (all hip orthotics – no RCT data)

Intervention: Patellar taping – Knee

Recommendation

We are unable to recommend either for or against the use of patellar taping for people with knee OA

Strength of recommendation

Conditional (neutral) recommendation

Quality of evidence

Very low

Intervention: Pulsed electromagnetic/ shortwave therapy – Knee and/or hip

Recommendation

We are unable to recommend either for or against electromagnetic/shortwave therapy for people with knee and/or hip OA

Strength of recommendation

Conditional (neutral) recommendation

Quality of evidence

Low (knee)
Very low (hip)

Intervention: Pulsed electromagnetic/ shortwave therapy – Knee and/or hip

Recommendation

We are unable to recommend either for or against electromagnetic/shortwave therapy for people with knee and/or hip OA

Strength of recommendation

Conditional (neutral) recommendation

Quality of evidence

Low (knee)
Very low (hip)

Intervention: Paracetamol – Knee and/or hip

Recommendation

We are unable to recommend either for or against the use of paracetamol for people with knee and/or hip OA

However, it might be reasonable to trial paracetamol for a short period and then discontinue use if it is not effective. Clinicians also need to monitor and capture adverse events that may be associated with its use

Strength of recommendation

Conditional (neutral) recommendation

Quality of evidence

Very low

Intervention: Topical NSAIDs – Knee and/or hip

Recommendation

We are unable to recommend either for or against the use of topical NSAIDs for people with knee and/or hip OA

It might be reasonable to trial topical NSAIDs for a short period and then discontinue use if not effective. Clinicians also need to monitor and capture the adverse effects along with its use

Strength of recommendation

Conditional (neutral) recommendation

Quality of evidence

Moderate

Intervention: Topical capsaicin – Hip

Recommendation

We are unable to recommend either for or against the use of topical capsaicin for people with hip OA

Strength of recommendation

Conditional (neutral) recommendation

Quality of evidence

Very low

Intervention: PRP injection – Knee and/or hip

Recommendation

We are unable to recommend either for or against the use of PRP injection for people with knee and/or OA

Strength of recommendation

Conditional (neutral) recommendation

Quality of evidence

Very low

Intervention: ASU – Knee and/or hip

Recommendation

We are unable to recommend for or against the use of ASU for people with knee and/or hip OA

Strength of recommendation

Conditional (neutral) recommendation

Quality of evidence

Very low

Intervention: Boswellia serrata extract – Knee and/or hip

Recommendation

We are unable to recommend for or against the use of Boswellia serrata for people with knee and/or hip OA

Strength of recommendation

Conditional (neutral) recommendation

Quality of evidence

Very low

Intervention: Curcuma/curcuminoid – Knee and/or hip

Recommendation

We are unable to recommend for or against the use of curcuma/curcuminoid for people with knee and/or hip OA

Strength of recommendation

Conditional (neutral) recommendation

Quality of evidence

Low

Intervention: Pine bark extract – Knee and/or hip

Recommendation

We are unable to recommend either for or against the use of pine bark extract for people with knee and/or hip OA

Strength of recommendation

Conditional (neutral) recommendation

Quality of evidence

Low (knee)
Very low (hip)

Intervention: Collagen – Knee and/or hip

Recommendation

We are unable to recommend either for or against the use of collagen for people with knee and/or hip OA

Strength of recommendation

Conditional (neutral) recommendation

Quality of evidence

Low (knee)
Very low (hip)

Intervention: MSM – Knee and/or hip

Recommendation

We are unable to recommend either for or against the use of MSM for people with knee and/or hip OA

Strength of recommendation

Conditional (neutral) recommendation

Quality of evidence

Very low

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