Therapeutic approaches in the management of knee osteoarthritis (Review)

Uivaraseanu,Bogdan; Vesa,Cosmin Mihai; Tit,Delia Mirela; Abid,Areha; Maghiar,Octavian; Maghiar,Teodor Andrei; Hozan,Calin; Nechifor,Aurelia Cristina; Behl,Tapan; Patrascu,Jenel Marian; Bungau,Simona

doi:10.3892/etm.2022.11257

Therapeutic approaches in the management of knee osteoarthritis (Review)

Authors:
- Bogdan Uivaraseanu
- Cosmin Mihai Vesa
- Delia Mirela Tit
- Areha Abid
- Octavian Maghiar
- Teodor Andrei Maghiar
- Calin Hozan
- Aurelia Cristina Nechifor
- Tapan Behl
- Jenel Marian Patrascu
- Simona Bungau
View Affiliations

Affiliations: Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410081, Romania, Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410081, Romania, Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, Oradea 410028, Romania, Department of Food Science, Faculty of Agricultural and Food Sciences, University of Debrecen, Debrecen 4032, Hungary, Department of Analytical Chemistry and Environmental Engineering, Polytechnic University of Bucharest, Bucharest 011061, Romania, Department of Pharmacology, Chitkara College of Pharmacy, Chitkara University, Punjab 140401, India, Department of Orthopedics, Urology and Medical Imaging, Faculty of Medicine, ‘Victor Babes’ University of Medicine and Pharmacy, Timisoara 300041, Romania
Published online on: March 15, 2022 https://doi.org/10.3892/etm.2022.11257
Article Number: 328

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Osteoarthritis (OA) is a common, frequently met degenerative disease, that generates pain and decreasing functionality; risk of suffering from this disorder increases with ageing. Being a complex disease, treatment is often difficult due to complications. Knee OA therapy demands a strategy that specialists agree with in considering the clinical symptoms and the disease evolution. The initial management of its treatment should be conservative requiring both a pharmacological and a non‑pharmacological approach. If this conservative, noninvasive therapy fails, the surgical approach is discussed. The present review focused on the assessment of therapy choices for patients with knee OA, in order to reduce pain and enhance functionality and knee range of motion, underlying benefits and advantages for each choice. Existing data of available treatment for knee OA, both surgical and nonsurgical were analyzed, focusing on the latest results, indications, developments, and level of evidence provided by the literature in the topic.

View Figures

View References

1	Magnusson K, Turkiewicz A and Englund M: Nature vs nurture in knee osteoarthritis-the importance of age, sex and body mass index. Osteoarthritis Cartilage. 27:586–592. 2019.PubMed/NCBI View Article : Google Scholar
2	Mahir L, Belhaj K, Zahi S, Azanmasso H, Lmidmani F and El Fatimi A: Impact of knee osteoarthritis on the quality of life. Ann phys Rehabil Med. 59(e159)2016.
3	Kisand K, Tamm AE, Lintrop M and Tamm AO: New insights into the natural course of knee osteoarthritis: Early regulation of cytokines and growth factors, with emphasis on sex-dependent angiogenesis and tissue remodeling. A pilot study. Osteoarthritis Cartilage. 26:1045–1054. 2018.PubMed/NCBI View Article : Google Scholar
4	Kellgren JH and Lawrence JS: Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 16:494–502. 1957.PubMed/NCBI View Article : Google Scholar
5	Ayhan E, Kesmezacar H and Akgun I: Intraarticular injections (corticosteroid, hyaluronic acid, platelet rich plasma) for the knee osteoarthritis. World J Orthop. 5:351–361. 2014.PubMed/NCBI View Article : Google Scholar
6	Bruyère O, Honvo G, Veronese N, Arden NK, Branco J, Curtis EM, Al-Daghri NM, Herrero-Beaumont G, Martel-Pelletier J, Pelletier JP, et al: An updated algorithm recommendation for the management of knee osteoarthritis from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Semin Arthritis Rheum. 49:337–350. 2019.PubMed/NCBI View Article : Google Scholar
7	Dulay GS, Cooper C and Dennison EM: Knee pain, knee injury, knee osteoarthritis & work. Best Pract Res Clin Rheumatol. 29:454–461. 2015.PubMed/NCBI View Article : Google Scholar
8	Robinson WH, Lepus CM, Wang Q, Raghu H, Mao R, Lindstrom TM and Sokolove J: Low-grade inflammation as a key mediator of the pathogenesis of osteoarthritis. Nat Rev Rheumatol. 12:580–592. 2016.PubMed/NCBI View Article : Google Scholar
9	Richards MM, Maxwell JS, Weng L, Angelos MG and Golzarian J: Intra-articular treatment of knee osteoarthritis: From anti-inflammatories to products of regenerative medicine. Phys Sportsmed. 44:101–108. 2016.PubMed/NCBI View Article : Google Scholar
10	Sellam J and Berenbaum F: The role of synovitis in pathophysiology and clinical symptoms of osteoarthritis. Nat Rev Rheumatol. 6:625–635. 2010.PubMed/NCBI View Article : Google Scholar
11	Messier SP, Gutekunst DJ, Davis C and DeVita P: Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis Rheum. 52:2026–2032. 2005.PubMed/NCBI View Article : Google Scholar
12	Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M and Bennell KL: Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 1(Cd004376)2015.PubMed/NCBI View Article : Google Scholar
13	Messier SP, Loeser RF, Miller GD, Morgan TM, Rejeski WJ, Sevick MA, Ettinger WH Jr, Pahor M and Williamson JD: Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: The arthritis, diet, and activity promotion trial. Arthritis Rheum. 50:1501–1510. 2004.PubMed/NCBI View Article : Google Scholar
14	Phillips S, Li CS, Phillips M, Bischoff M, Ali P, Chahal J, Snider M and Bhandari M: Treatment of osteoarthritis of the knee with bracing: A scoping review. Orthop Rev (Pavia). 8(6256)2016.PubMed/NCBI View Article : Google Scholar
15	Moyer RF, Birmingham TB, Bryant DM, Giffin JR, Marriott KA and Leitch KM: Valgus bracing for knee osteoarthritis: A meta-analysis of randomized trials. Arthritis Care Res (Hoboken). 67:493–501. 2015.PubMed/NCBI View Article : Google Scholar
16	Segal NA, Glass NA, Felson DT, Hurley M, Yang M, Nevitt M, Lewis CE and Torner JC: Effect of quadriceps strength and proprioception on risk for knee osteoarthritis. Med Sci Sports Exerc. 42:2081–2088. 2010.PubMed/NCBI View Article : Google Scholar
17	Brosseau L, Taki J, Desjardins B, Thevenot O, Fransen M, Wells GA, Mizusaki Imoto A, Toupin-April K, Westby M, Álvarez Gallardo IC, et al: The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part two: Strengthening exercise programs. Clin Rehabil. 31:596–611. 2017.PubMed/NCBI View Article : Google Scholar
18	Gore M, Tai KS, Sadosky A, Leslie D and Stacey BR: Use and costs of prescription medications and alternative treatments in patients with osteoarthritis and chronic low back pain in community-based settings. Pain Pract. 12:550–560. 2012.PubMed/NCBI View Article : Google Scholar
19	da Costa BR, Reichenbach S, Keller N, Nartey L, Wandel S, Jüni P and Trelle S: Effectiveness of non-steroidal anti-inflammatory drugs for the treatment of pain in knee and hip osteoarthritis: A network meta-analysis. Lancet. 390:e21–e33. 2017.PubMed/NCBI View Article : Google Scholar
20	Garcia Rodríguez LA and Hernández-Díaz S: The risk of upper gastrointestinal complications associated with nonsteroidal anti-inflammatory drugs, glucocorticoids, acetaminophen, and combinations of these agents. Arthritis Res. 3:98–101. 2001.PubMed/NCBI View Article : Google Scholar
21	Coxib and traditional NSAID Trialists' (CNT) Collaboration. Bhala N, Emberson J, Merhi A, Abramson S, Arber N, Baron JA, Bombardier C, Cannon C, Farkouh ME, et al: Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: Meta-analyses of individual participant data from randomised trials. Lancet. 382:769–779. 2013.PubMed/NCBI View Article : Google Scholar
22	Rannou F, Pelletier JP and Martel-Pelletier J: Efficacy and safety of topical NSAIDs in the management of osteoarthritis: Evidence from real-life setting trials and surveys. Semin Arthritis Rheum. 45 (4 Suppl):S18–S21. 2016.PubMed/NCBI View Article : Google Scholar
23	Derry S, Conaghan P, Da Silva JA, Wiffen PJ and Moore RA: Topical NSAIDs for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev. 4(Cd007400)2016.PubMed/NCBI View Article : Google Scholar
24	Bradley JD, Brandt KD, Katz BP, Kalasinski LA and Ryan SI: Comparison of an antiinflammatory dose of ibuprofen, an analgesic dose of ibuprofen, and acetaminophen in the treatment of patients with osteoarthritis of the knee. N Engl J Med. 325:87–91. 1991.PubMed/NCBI View Article : Google Scholar
25	Davies JE: The pharmacological basis of therapeutics. Occup Environ Med. 64(e2)2007.
26	Rodriguez-Merchan EC: Intra-articular injections of hyaluronic acid and other drugs in the knee joint. HSS J. 9:180–182. 2013.PubMed/NCBI View Article : Google Scholar
27	Raeissadat SA, Rayegani SM, Hassanabadi H, Fathi M, Ghorbani E, Babaee M and Azma K: Knee osteoarthritis injection choices: Platelet-rich plasma (PRP) versus hyaluronic acid (A one-year randomized clinical trial). Clin Med Insights Arthritis Musculoskelet Disord. 8:1–8. 2015.PubMed/NCBI View Article : Google Scholar
28	Uth K and Trifonov D: Stem cell application for osteoarthritis in the knee joint: A minireview. World J Stem Cells. 6:629–636. 2014.PubMed/NCBI View Article : Google Scholar
29	Chang RW, Falconer J, Stulberg SD, Arnold WJ, Manheim LM and Dyer AR: A randomized, controlled trial of arthroscopic surgery versus closed-needle joint lavage for patients with osteoarthritis of the knee. Arthritis Rheum. 36:289–296. 1993.PubMed/NCBI View Article : Google Scholar
30	Ogilvie-Harris DJ and Fitsialos DP: Arthroscopic management of the degenerative knee. Arthroscopy. 7:151–157. 1991.PubMed/NCBI View Article : Google Scholar
31	Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, Bierma-Zeinstra S, Brandt KD, Croft P, Doherty M, et al: OARSI recommendations for the management of hip and knee osteoarthritis, part I: Critical appraisal of existing treatment guidelines and systematic review of current research evidence. Osteoarthritis Cartilage. 15:981–1000. 2007.PubMed/NCBI View Article : Google Scholar
32	Moseley JB, O'Malley K, Petersen NJ, Menke TJ, Brody BA, Kuykendall DH, Hollingsworth JC, Ashton CM and Wray NP: A controlled trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med. 347:81–88. 2002.PubMed/NCBI View Article : Google Scholar
33	Siparsky P, Ryzewicz M, Peterson B and Bartz R: Arthroscopic treatment of osteoarthritis of the knee: Are there any evidence-based indications? Clin Orthop Relat Res. 455:107–112. 2007.PubMed/NCBI View Article : Google Scholar
34	Dervin GF, Stiell IG, Rody K and Grabowski J: Effect of arthroscopic débridement for osteoarthritis of the knee on health-related quality of life. J Bone Joint Surg Am. 85:10–19. 2003.PubMed/NCBI View Article : Google Scholar
35	Hubbard MJ: Articular debridement versus washout for degeneration of the medial femoral condyle. A five-year study. J Bone Joint Surg Br. 78:217–219. 1996.PubMed/NCBI
36	Jackson RW and Rouse DW: The results of partial arthroscopic meniscectomy in patients over 40 years of age. J Bone Joint Surg Br. 64:481–485. 1982.PubMed/NCBI View Article : Google Scholar
37	Rand JA: Role of arthroscopy in osteoarthritis of the knee. Arthroscopy. 7:358–363. 1991.PubMed/NCBI View Article : Google Scholar
38	Lobenhoffer P, van Heerwaarden RJ, Staubli AE, Jakob RP, Galla M and Agneskirchner JD (eds): Osteotomies around the knee: Indications, planning, surgical techniques using plate fixators. Vol 1. 1st edition. AO Publishing, Davos, Switzerland, 2008.
39	Brouwer RW, Huizinga MR, Duivenvoorden T, van Raaij TM, Verhagen AP, Bierma-Zeinstra SM and Verhaar JA: . Osteotomy for treating knee osteoarthritis. Cochrane Database Syst Rev. 2014(CD004019)2014.PubMed/NCBI View Article : Google Scholar
40	Jackson J and Waugh W: Tibial osteotomy for osteoarthritis of the knee. J Bone Joint Surg Br. 43-B:746–751. 1961.PubMed/NCBI View Article : Google Scholar
41	Amendola A and Bonasia DE: Results of high tibial osteotomy: Review of the literature. Int Orthop. 34:155–160. 2010.PubMed/NCBI View Article : Google Scholar
42	Uivaraseanu B, Vesa CM, Tit DM, Maghiar O, Maghiar TA, Hozan C, Nechifor AC, Behl T, Andronie-Cioara FL, Patrascu JM and Bungau S: Highlighting the advantages and benefits of cementless total knee arthroplasty (Review): Exp Ther. Med. 23(58)2022.PubMed/NCBI View Article : Google Scholar
43	Staubli AE, De Simoni C, Babst R and Lobenhoffer P: TomoFix: A new LCP-concept for open wedge osteotomy of the medial proximal tibia-early results in 92 cases. Injury. 34 (Suppl 2):B55–B62. 2003.PubMed/NCBI View Article : Google Scholar
44	Wagner M, Frenk A and Frigg R: New concepts for bone fracture treatment and the locking compression plate. Surg Technol Int. 12:271–277. 2004.PubMed/NCBI
45	Maquet PGJ: Biomechanics of the knee: With application to the pathogenesis and the surgical treatment of osteoarthritis. Springer Science & Business Media, 2012.
46	Maquet P: Valgus osteotomy for osteoarthritis of the knee. Clin Orthop Relat Res. 143–148. 1976.PubMed/NCBI
47	Fujisawa Y, Masuhara K and Shiomi S: The effect of high tibial osteotomy on osteoarthritis of the knee. An arthroscopic study of 54 knee joints. Orthop Clin North Am. 10:585–608. 1979.PubMed/NCBI
48	Chahla J, Dean CS, Mitchell JJ, Moatshe G, Serra Cruz R and LaPrade RF: Medial opening wedge proximal tibial osteotomy. Arthrosc Tech. 5:e919–e928. 2016.PubMed/NCBI View Article : Google Scholar
49	Green SA: Principles of deformity correction. J Bone Joint Surg. 84:1293–1294. 2002.
50	Marmor L: Marmor modular knee in unicompartmental disease. Minimum four-year follow-up. J Bone Joint Surg Am. 61:347–353. 1979.PubMed/NCBI
51	Murray DW: Unicompartmental knee replacement: Now or never? Orthopedics. 23:979–980. 2000.PubMed/NCBI View Article : Google Scholar
52	Møller JT, Weeth RE, Keller JO and Nielsen S: Unicompartmental arthroplasty of the knee. Cadaver study of the importance of the anterior cruciate ligament. Acta Orthop Scand. 56:120–123. 1985.PubMed/NCBI View Article : Google Scholar
53	Obeid EM, Adams MA and Newman JH: Mechanical properties of articular cartilage in knees with unicompartmental osteoarthritis. J Bone Joint Surg Br. 76:315–319. 1994.PubMed/NCBI
54	Ridgeway SR, McAuley JP, Ammeen DJ and Engh GA: The effect of alignment of the knee on the outcome of unicompartmental knee replacement. J Bone Joint Surg Br. 84:351–355. 2002.PubMed/NCBI View Article : Google Scholar
55	Borus T and Thornhill T: Unicompartmental knee arthroplasty. J Am Acad Orthop Surg. 16:9–18. 2008.PubMed/NCBI View Article : Google Scholar
56	Boehler NM: Unicompartmental knee arthroplasty. In: Knee Arthroplasty. Springer, pp113-119, 2001.
57	Koskinen E, Paavolainen P, Eskelinen A, Pulkkinen P and Remes V: Unicondylar knee replacement for primary osteoarthritis: A prospective follow-up study of 1,819 patients from the Finnish Arthroplasty Register. Acta Orthop. 78:128–135. 2007.PubMed/NCBI View Article : Google Scholar
58	Svärd UC and Price AJ: Oxford medial unicompartmental knee arthroplasty. A survival analysis of an independent series. J Bone Joint Surg Br. 83:191–194. 2001.PubMed/NCBI View Article : Google Scholar
59	Buly RL and Sculco TP: Recent advances in total knee replacement surgery. Curr Opin Rheumatol. 7:107–113. 1995.PubMed/NCBI View Article : Google Scholar
60	Keating EM, Meding JB, Faris PM and Ritter MA: Long-term followup of nonmodular total knee replacements. Clin Orthop Relat Res. 404:34–39. 2002.PubMed/NCBI View Article : Google Scholar
61	Rand JA and Ilstrup DM: Survivorship analysis of total knee arthroplasty. Cumulative rates of survival of 9200 total knee arthroplasties. J Bone Joint Surg Am. 73:397–409. 1991.PubMed/NCBI
62	Lundblad H, Kreicbergs A and Jansson KA: Prediction of persistent pain after total knee replacement for osteoarthritis. J Bone Joint Surg Br. 90:166–171. 2008.PubMed/NCBI View Article : Google Scholar
63	Ritter MA, Lutgring JD, Davis KE, Berend ME, Pierson JL and Meneghini RM: The role of flexion contracture on outcomes in primary total knee arthroplasty. J Arthroplasty. 22:1092–1096. 2007.PubMed/NCBI View Article : Google Scholar
64	Smith AJ, Wood DJ and Li MG: Total knee replacement with and without patellar resurfacing: A prospective, randomised trial using the profix total knee system. J Bone Joint Surg Br. 90:43–49. 2008.PubMed/NCBI View Article : Google Scholar
65	Burnett RS, Boone JL, McCarthy KP, Rosenzweig S and Barrack RL: A prospective randomized clinical trial of patellar resurfacing and nonresurfacing in bilateral TKA. Clin Orthop Relat Res. 464:65–72. 2007.PubMed/NCBI View Article : Google Scholar
66	Lonner JH and Lotke PA: Aseptic complications after total knee arthroplasty. J Am Acad Orthop Surg. 7:311–324. 1999.PubMed/NCBI View Article : Google Scholar
67	Uivaraseanu B, Bungau S, Tit DM, Behl T, Maghiar TA, Maghiar O, Pantis C, Zaha DC and Patrascu JM: Orthopedic surgery approach with uncemented metallic prosthesis in knee osteoarthritis increases the quality of life of young patients. Exp Ther Med. 21(541)2021.PubMed/NCBI View Article : Google Scholar