BMJ  2005;330:673 (19 March), doi:10.1136/bmj.330.7492.673

Letter

Managing osteoarthritis of the knee

Holistic approach is important

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

EDITOR—The editorial by MacAuley on managing osteoarthritis of the knee provides a welcome emphasis on the EULAR recommended, holistic, multidisciplinary approach to the condition.¹

Excessive prescribing of non-steroidal anti-inflammatory drugs in primary care reflects the dependence of health professionals on "medicines based evidence" rather than evidence based medicine and the chronic underinvestment in other approaches to osteoarthritis of the knee.² No reference was made to evidence of benefit of weight loss programmes linked to exercise; this is important, since increasing levels of obesity and incident knee osteoarthritis are strongly associated.³ Even relatively small amounts of weight loss can reduce pain and improve activity levels. At the point at which knee replacement is appropriate, severely disabled patients with a high body mass index may be denied surgery.

MacAuley comments that physiotherapy may delay decline. Community physiotherapists could have a central role in the treatment of knee osteoarthritis, using motivating . . . [Full text of this article]

Woodhouse Medical Centre, Sheffield S13 7LY C.Mitchell@sheffield.ac.uk

Barnsley District General Hospital, Barnsley S75 2ED

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Relevant Article

Managing osteoarthritis of the knee

Domhnall MacAuley
BMJ 2004 329: 1300-1301. [Extract] [Full Text] [PDF]