The Specialist Forum Volume 13 No 11 November 2013 | Page 45

ARTHRITIS

Procedural treatments
Recommendation 8
The AAOS is unable to recommend for or against the use of intraarticular (IA) corticosteroids for patients with symptomatic OA of the knee.

Recommendation 9
The AAOS cannot recommend using hyaluronic acid for patients with
symptomatic OA of the knee.

Recommendation 10
The AAOS is unable to recommend for or against growth factor injections and/or platelet rich plasma for patients with symptomatic OA of
the knee.

Recommendation 11
The AAOS cannot suggest that the practitioner use needle lavage for
patients with symptomatic osteoarthritis of the knee.

Surgical treatments
Recommendation 12
The AAOS cannot recommend performing arthroscopy with lavage
and/or debridement in patients with a primary diagnosis of symptomatic osteoarthritis of the knee.

Recommendation 13
The AAOS is unable to recommend for or against arthroscopic partial
meniscectomy in patients with osteoarthritis of the knee with a torn
meniscus.

Recommendation 14
The practitioner might perform a valgus producing proximal tibial osteotomy in patients with symptomatic medial compartment osteoarthritis
of the knee.

Recommendation 15
In the absence of reliable evidence, it is the opinion of the AAOS work
group not to use the free-floating (unfixed) interpositional device in patients with symptomatic medial compartment OA of the knee.? R

Rheumatology Forum | November 2013

Efficacy of methotrexate for knee
osteoarthritis
University of Leeds researchers are to carry out a major new
Arthritis Research UK-funded clinical trial that could bring relief
to millions of people worldwide with the potentially crippling condition of osteoarthritis of the knee.
Prof Philip Conaghan, a leading UK authority on musculoskeletal conditions, has been awarded funding by the Chesterfieldbased medical research charity to run a multi-centre clinical trial,
which aims to test the effectiveness of a drug called methotrexate (MTX) in relieving the pain of osteoarthritis of the knee.
MTX is already successfully and widely used to treat people
with the condition of rheumatoid arthritis, a completely different
condition to osteoarthritis. Both conditions can lead to severe
joint pain and stiffness but while rheumatoid arthritis is a serious
autoimmune condition that causes inflammation in the joints,
osteoarthritis is a degenerative joint disease in which c 'F??vP?vV'2v?BF?RV?G2?b&??W2??vWfW"?66?&F??rF?&?b6??v???bF?R?VVG2??7F?GWFR?`?&?WV?F???w??B?W67V??6?V?WF??VF?6??R&6VBB6?V????W'F????7?F??&V6V?B7GVF?W2?fR7VvvW7FVBF?B??f???F????2?6????'F?B??6W6??r?????7FV?'F?&?F?2?R?B6???VwVW2?fR?&VG?W&f?&?VB???B7GVG?v??6??6??vVBF?B3rR?bF?V?G2v?F??7FV?'F?&?F?2?bF?R??VRv???F????E??BCR&VGV7F?????F?V?"????( ?7W'&V?BG'VrG&VF?V?G2f?"??VR?7FV?'F?&?F?2&R??FVB???F?BF?W??fR6?v??f?6?B6?FRVffV7G2?B&R??B7V?F&?Rf? ????V??R?( ?W????VB&?b6??v???( ?2&W7V?B?V??P?v?F??7FV?'F?&?F?2?gFV??fRv?F?6WfW&R???B?fR6?v??f?6?BF?ff?7V?G???6''???r?WBF?V?"??&??F??F??F?7F?f?F?W2??F?W&R?2F?W&Vf?&R?W&vV?B?VVBF?f??B?Wr?B&WGFW"v?2?`???v??rF?V?"???( ?WF?cV??Rv?F???FW&FRF?6WfW&R?7FV?'F?&?F?2?bF?P???VRg&??R6V?G&W2&?V?BF?RT??v??&R??BvWGF??r&V?Vf?@?g&??G&F?F????G&VF?V?G27V6?2????W'2?v???&R&V7'V?FV@???F?F?RG&??g&??V&?#B??b?bF??6R&V7'V?FVBv???F?R?E?f?""???F?2?BF?P??F?W"??bv???F?R?6V&?F&?WB???F?V?G2v????fR??v?WF?2&W6???6R??vR??$??F?V??bF?V?"??VR??Bf??????VW7F?????&W2WfW'?F?&VR???F?2??F?R?V?&W"?bV??RffV7FVB'??7FV?'F?&?F?2?2??7&V6V@?Gv??F??f?W"f??B?fW"F?R7BS?V'22F?R?V?F???vW0??B&V6??W2??&R?&W6R( 2Gv????"&?6?f7F?'2f?"FWfV????r?7FV?'F?&?F?2?F?R6??F?F???66?V?G2f?"??&RF??F??&@??b6?&???2??FW&FRF?6WfW&R????F?RT???????W'2??W66?R?7G&V?wF?V???r?W?W&6?6R??BvV?v?B??70?6????V?F???vRF?R6??F?F????v???R????B&W?6V?V?@?7W&vW'?6?&RW?G&V?V?VffV7F?fRf?"V??Rv?F?6WfW&R?V?G7FvR?7FV?'F?&?F?2?'WBF?W&R&V???2?6???v?VFvVBG&VF?V?Bv??B??&RVffV7F?fRf?&?2?b??&V?Vb&RW&vV?F???VVFVB??&?b6??v???2?6?'V????r?'F?&?F?2&W6V&6?T?gV?FVBG&??FW7F??rF?RVffV7F?fV?W72?b??F?W"G'Vr6???????W6VBF?G&VB&?WV?F??B'F?&?F?26??VB??G&???6???&?V??R?????7FV?'F?&?F?2?bF?R??B?(" ?6?W&6S?'F?&?F?2&W6V&6?T???vR???