Despite its prevalence, no effective pharmacotherapies have been definitively proven to modify the course of radiographic knee osteoarthritis (OA). Risedronate, a bisphosphonate that reduces bone turnover, has been shown in animal models to inhibit cartilage degradation and progression of disease.
Mechanical forces exerted on the knee contribute to the development of knee osteoarthritis (OA). Among these, the additional torque about the knee associated with increasing leg length may predispose people of taller stature to knee OA. However, this association has received little prior investigation. In contrast to body height, which may decrease with age, knee height is relatively constant, making knee height a more appropriate surrogate for stature in the elderly.
Total knee replacement (TKR) is an effective, yet underutilized, treatment for severe knee osteoarthritis (OA). In particular, eligible minority patients tend to undergo TKR less often than white patients. The origins of these racial/ethnic disparities are incompletely understood, but may include both care-based (e.g. physician bias for recommending TKR) and patient-based (e.g. decisions not to undergo TKR if recommended) factors.
Preliminary evidence from experimental animal models has suggested that doxycycline may be effective in preventing or slowing the progression of osteoarthritis (OA), perhaps through its ability to modulate the activity of cartilage-degrading matrix metalloproteases (MMPs). Despite this encouraging animal evidence, no studies have investigated doxycycline in humans with, or at risk for, OA. Here, Brandt […]
Injuries to the internal supporting structures of the knee (i.e., ligaments and menisci) have been shown increase the risk of knee OA, particularly in athletes with knee injuries early in life. Unrecognized degenerative damage to these structures may also predispose to an increased risk of knee OA. Here, Hill et al (Arthritis Rheum 52(3):794, 2005) […]
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.