Designed and created by Guideline Central in participation with the Veterans Health Administration / Department of Defense
Non-Surgical Management of Hip & Knee Osteoarthritis
Publication Date: July 1, 2020
Last Updated: March 3, 2023
Objective
Objective
This patient summary means to discuss key recommendations from the Department of Veterans Affairs, the Department of Defense, for non-surgical management of hip and knee osteoarthritis. This patient summary is limited to adults 18 years of age and older and should not be used as a reference for children.
Overview
Overview
- Osteoarthritis describes a common, progressive degeneration of joints.
- Osteoarthritis is generally considered a wear and tear disease from overuse, but there also appears to be some genetic influence.
- Symptoms include pain and limitation of function.
- This patient summary focuses on the non-surgical management of osteoarthritis in the hips and knees.
Diagnosis
Diagnosis
- Diagnosis is usually clear from your history and an examination of the joints affected.
- Consequently, imaging is rarely needed unless surgery is being considered.
Treatment
Treatment
- The VA suggests a self-management program including exercise, weight loss and, for the knee, bracing.
- Physical therapy is included in a comprehensive management program.
- The VA recommends topical non-steroidal anti-inflammatory drugs and suggests topical capsaicin for knee pain.
- The VA suggests acetaminophen and/or oral non-steroidal anti-inflammatory drugs for hip or knee pain.
- An alternative is duloxetine.
- For persistent hip or knee pain, the VA suggests:
- cortisone injection (image-guided for the hip)
- 2nd choice: viscosupplementation injection(s) for the knee (an artificial substitute for joint fluid)
- There is insufficient evidence for benefits from:
- nutritional supplements
- massage
- light touch
- meditation
- tai chi
- yoga
- transcutaneous electrical nerve stimulation
Abbreviations
- VA: Veterans Administration
Source Citation
Krishnamurthy A, Lang AE, Pangarkar S, Edison J, Cody J, Sall J. Synopsis of the 2020 US Department of Veterans Affairs/US Department of Defense Clinical Practice Guideline: The Non-Surgical Management of Hip and Knee Osteoarthritis. Mayo Clin Proc. 2021 Sep;96(9):2435-2447. doi: 10.1016/j.mayocp.2021.03.017. PMID: 34481599.
Disclaimer
The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.