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Many Common Ways Of Treating
Knee Osteoarthritis Have No Scientific Support
edited by Joint-Pain-Forum.com
new scientific review released today by HHS' Agency for Healthcare
Research and Quality concludes that evidence of benefit is lacking for
many common ways of treating osteoarthritis of the knee, including
popular dietary supplement ingredients, a common surgical procedure,
and injected preparations.
The review found that
glucosamine and chondroitin, over-the-counter dietary supplement
ingredients that are used widely because of their purported benefits to
relieve knee pain caused by osteoarthritis and improve physical
functioning, appear to be no more effective than placebos. A placebo is
a harmless substance given to selected patients in a clinical trial
that looks like the real drug or injection being studied, but which has
no medical effect.
The review, which was requested
and funded by HHS' Centers for Disease Control and Prevention, also
failed to find convincing evidence of benefit from arthroscopic surgery
to clean the knee joint with or without removal of debris and loose
Published studies generally report that
injections with hyaluronan preparations (substances that are intended
to improve lubrication of the knee joint) improve scores on patient
questionnaires used to measure pain and function. However, the evidence
is uncertain because of variation in study quality and difficulty
determining whether changes in scores translate into real clinical
improvements for patients.
"Millions of Americans
seek relief from the pain and reduced mobility caused by osteoarthritis
of the knee," said AHRQ Director Carolyn M. Clancy, M.D. "However, they
should work with their clinicians to decide the best course of
treatment for them based on what has and has not been proven to work."
www.Joint-Pain-Forum.com from original press release.
Osteoarthritis is a widespread, costly
disease that wears away the cartilage cushioning the knee joint,
causing pain and reducing mobility. Arthritic diseases, which include
osteoarthritis, affect an estimated 46 million people in the United
States, and at age 64 and older, one in 10 Americans is estimated to
have osteoarthritis of the knee. Osteoarthritis and related arthritic
conditions cost more than $81 billion a year in medical care, lost
wages, and other expenses.
The authors, who were led
by David J. Samson, M.S., associate director of the AHRQ-supported Blue
Cross and Blue Shield Association Evidence-based Practice Center in
Chicago, reviewed findings from 53 randomized clinical trials of
glucosamine, chrondroitin, and injections with hyaluronan preparations
and 23 studies of arthroscopy. The review scrutinized individual
studies concerned with these treatments' effects as well as
meta-analyses that analyzed the combined evidence of groups of studies.
to authors, better quality randomized clinical trials are needed to
clarify whether these treatments are beneficial. However, given the
aging of the population and increasing prevalence of obesity both risk
factors for osteoarthritis of the knee "research on new approaches to
prevention and treatment of osteoarthritis of the knee should be a high
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