Management of Osteoarthritis- Updated ACR/AF Guidelines

Atlanta, (GLOBE NEWSWIRE) -- American College of Rheumatology (ACR) and the Arthritis Foundation (AF), have released the 2019 ACR/AF Guideline for the Management of Osteoarthritis of the Hand, Hip and Knee. This is an update on 2012 guidelines in which direct patient participation has been incorporated for the first time. The guidelines have been published in Arthritis Care and Research.

Osteoarthritis (OA) is a common disease that affects the entire joint, involving the cartilage, joint lining, ligaments, and bone. According to the Arthritis Foundation, approximately 27 million Americans suffer from the disease. Researches are in the process of finding effective management and treatment for Osteoarthritis.

"Patients with osteoarthritis can vary quite a bit in how the disease affects them. They might have a single joint, a few joints or many joints that are involved where symptoms can occur throughout adult life," said Sharon Kolasinski, MD, a practising rheumatologist who served as lead author for the guideline update. "The new guideline recognizes not only the variety of clinical presentations of OA but also the broad array of treatment options available. Clinicians and patients can choose from educational, behavioural, psychosocial, mind-body, physical and pharmacological approaches. It's important to remember that treatment for OA is not one size fits all. Over time, various options might be used then reused or changed in response to a change in the patient's symptoms."

"We are proud to have been involved in this work and to facilitate the important contributions of the patient and parent partners," said Cindy McDaniel, Arthritis Foundation's Senior Vice President of Consumer Affairs. "Their lived experiences truly helped to guide this project."

Key Recommendations include_

• Weight loss and self-management programs to build fitness skills and exercise goal‑setting.


• A new conditional recommendation for balance exercises for knee and hip osteoarthritis and duloxetine for knee osteoarthritis.


• A conditional recommendation for using topical capsaicin in patients with knee osteoarthritis (previously conditional against).


• New conditional recommendations for using yoga, cognitive behavioral therapy, radiofrequency ablation and kinesiotaping for first carpometacarpal and knee osteoarthritis.


• A conditional recommendation against using manual therapy with exercise for knee and hip osteoarthritis (previously was conditionally for usage).


• A strong recommendation against transcutaneous electric nerve stimulation for knee and hip osteoarthritis (previously was a conditional recommendation).


• A new conditional recommendation against using intra-articular hyaluronic acid injections in first carpometacarpal and knee osteoarthritis.


• A new strong recommendation against using hyaluronic acid injections in patients with hip osteoarthritis.

Additionally, recommendations were made against the use of bisphosphonates, hydroxychloroquine, methotrexate, PRP injections (in hip and knee OA), stem cell injections (in hip and knee OA), tumor necrosis factor inhibitors and interleukin-1 receptor antagonists. "A number of agents have been tested and fail to show adequate benefit to justify their use, while others will require additional investigations to clarify their place in the OA armamentarium," said Dr. Kolasinski. "The recommendations against usage of these therapies reflects the fact that pharmacologic options remain limited for the management of OA. A broad suggested research agenda is outlined in the guideline to address this gap."

For further reference log on to :

"2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee." January 2020. Arthritis Care and Research. DOI:10.1002/acr.24131