Managing osteoarthritis of the knee

doi:10.1136/bmj.329.7478.1300

BMJ 2004;329:1300-1301 (4 December), doi:10.1136/bmj.329.7478.1300

Editorial

Managing osteoarthritis of the knee

NSAIDs and other measures offer only short term benefits—upto surgery

The first 150 words of the full text of this article appear below.

A slightly swollen and aching knee. Walking is difficult, thestairs are almost impossible, and so begins the downward spiralof inactivity, immobility, and weight gain. Osteoarthritis ofthe knee is a familiar picture, presenting usually when it istoo painful to ignore but too early for surgery. Patients haveoften already made the diagnosis themselves and seek a solution.They want pain relief so they can walk, kneel, climb a ladder,shop, or simply get around in comfort. Most patients have triedparacetamol, hot water bottles, someone else's great new tablets,a cabbage leaf, various herbal or homoeopathic medications,prayer, copper bracelets, and many other remedies before askingfor help. Most general practitioners would reach for the keyboardtapping out their favourite non-steroidal anti-inflammatory(NSAID).

NSAIDs do not seem to offer a long term solution. In a comprehensivesystematic review and meta-analysis of randomised placebo controlledtrials in this . . . [Full text of this article]

Domhnall MacAuley, general practitioner

Hillhead Family Practice, Belfast BT11 9FZ (domhnall.macauley@ntlworld.com)

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