The prevalence of both obesity and musculoskeletal pain continue to increase dramatically in the United States and the developed world. In the United States, approximately 1/3 of the adult population are classified as obese (i.e., body mass index: BMI > 30), while musculoskeletal pain is the leading cause of work-related disability among the US workforce […]
Intra-articular injections of hyaluronic acid have been available for the treatment of knee OA since 1997. The assumed, but unproved, mechanism of action involves both augmentation of the viscous properties of the articular compartment and promotion of normal hyaluronic acid production by synovial membrane. Widespread acceptance of the compounds efficacy has been hindered by the […]
Non-steroidal anti-inflammatory drugs (NSAIDs) and intraarticular corticosteroid and hyaluronate injections are the standards of care for osteoarthritis (OA) of the knee. However, long-term NSAID usage can cause gastrointestinal bleeding in some patients. The advent of selective COX-2 inhibitors has reduced this risk, but there remains significant concern with the systemic toxicities of NSAIDs. Intraarticular injections […]
As osteoarthritis (OA) of the knee progresses in severity, the pain can become refractive to medical therapies such as acetaminophen and nonsteroidal anti-inflammatory medications, and intra-articular injections of corticosteroids and hyaluronate. Surgical lavage and/or debridement by arthroscopy is sometimes recommended to patients at this point. Prior studies touting the benefits of arthroscopic surgery for knee […]
Increased body weight is thought to increase the risk of knee osteoarthritis (OA) by increasing the amount of mechanical knee loading subjected to the knees with use. Accordingly, obesity is a well-established risk factor for the development of knee OA. However, weight alone may not completely identify risk, as body weight reflects distribution of body composition (adipose, lean tissue mass, and bone mass) that may differ between individuals and convey differing risk patterns for knee OA.