Summary of Recommendations

Document Overview

Design and created by Guideline Central in participation with the American Academy of Orthopaedic Surgeons.

Non-Arthroplasty Treatment of Osteoarthritis of the Knee

American Academy of Orthopaedic Surgeons

Publication Date: Sep 1, 2021

Page Last Updated: May 6, 2026

American Academy of Orthopaedic Surgeons + Grading System

Strength of Recommendation
Strength	Overall Strength of Evidence	Description of Evidence Quality
Strong	Strong	Evidence from two or more “High” quality studies with consistent findings for recommending for or against the intervention.
Moderate	Moderate	Evidence from two or more “Moderate” quality studies with consistent findings, or evidence from a single “High” quality study for recommending for or against the intervention.
Limited	Low Strength Evidence or Conflicting Evidence	Evidence from two or more “Low” quality studies with consistent findings or evidence from a single “Moderate” quality study recommending for against the intervention or diagnostic or the evidence is insufficient or conflicting and does not allow a recommendation for or against the intervention.
Inconclusive	Inadequate	Evidence from a single low-quality study or conflicting findings that do not allow a recommendation for or against the intervention.
Consensus*	No Evidence	There is no supporting evidence. In the absence of reliable evidence, the guideline development group is making a recommendation based on their clinical opinion. Consensus statements are published in a separate, complimentary document.
* The AAOS will issue a consensus-based recommendation only when the service in question has virtually no associated harm and is of low cost (e.g. a history and physical) or when not establishing a recommendation could have catastrophic consequences.

Document Overview

Document Title: Non-Arthroplasty Treatment of Osteoarthritis of the Knee

Authoring Society: American Academy of Orthopaedic Surgeons

Endorsing Society: American Association of Hip and Knee Surgeons

Document Publication Date: Sep 1, 2021

Page Last Reviewed/Updated: May 6, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: www.aaos.org/globalassets/quality-and-practice-resources/osteoarthritis-of-the-knee/oak3cpg.pdf

Source Citation: American Academy of Orthopaedic Surgeons Management of Osteoarthritis of the Knee (Non- Arthroplasty) Evidence-Based Clinical Practice Guideline. https://www.aaos.org/oak3cpg Published 08/31/2021

Document Scope, Criteria, and Use Cases

Scope: Assessment and Screening, Diagnosis, Rehabilitation, Treatment

Diseases/Conditions (MeSH)

D020370 - Osteoarthritis, Knee

Keywords: knee pain, nonpharmacological treatment, nonsteroidal anti-inflammatory drugs (NSAIDs), osteoarthritis, physical therapy

Target Patient Population: patients with knee osteoarthritis

Target Provider Population: orthopedic surgeons

Inclusion Criteria: Male, Female, Adult, Older Adult

Health Care Settings: Ambulatory, Home Health, Hospital, Outpatient

Intended Users: Nurse, Nurse Practitioner, Physical Therapist, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Supplemental Methodology Resource: Data Supplement

Number of Source Documents: 620

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: Yes

Non-Arthroplasty Treatment of Osteoarthritis of the Knee

Summary of Recommendations

Lateral Wedge Insoles

Canes

Braces

Oral/Dietary Supplements

Topical Treatments

Supervised Exercise

Neuromuscular Training

Self-Management

Patient Education

Weight Loss Intervention

Manual Therapy

Massage

Laser Treatment

Acupuncture

Transcutaneous Electrical Nerve Stimulation

Percutaneous Electrical Nerve Stimulation/Pulsed Electromagnetic Field Therapy

Extracorporeal Shockwave Therapy

Oral NSAIDs

Oral Acetaminophen

Oral Narcotics

Hyaluronic Acid

Intra-articular Corticosteroids

Platelet-rich Plasma

Denervation Therapy

Lavage/Debridement

Partial Meniscectomy

Tibial Osteotomy

Dry Needling

Free Floating Interpositional Devices

American Academy of Orthopaedic Surgeons + Grading System

Document Overview

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology