Comprehensive Review of Knee Osteoarthritis Pharmacological Treatment and the Latest Professional Societies’ Guidelines

Abstract

Osteoarthritis is the most common musculoskeletal progressive disease, with the knee as the most commonly affected joint in the human body. While several new medications are still under research, many symptomatic therapy options, such as analgesics (opioid and non-opioid), nonsteroid anti-inflammatory drugs, symptomatic slow-acting drugs in osteoarthritis, and preparations for topical administration, are being used, with a diverse clinical response and inconsistent conclusions across various professional societies guidelines. The concept of pharmacogenomic-guided therapy, which lies on principles of the right medication for the right patient in the right dose at the right time, can significantly increase the patient’s response to symptom relief therapy in knee osteoarthritis. Corticosteroid intra-articular injections and hyaluronic acid injections provoke numerous discussions and disagreements among different guidelines, even though they are currently used in daily clinical practice. Biological options, such as platelet-rich plasma and mesenchymal stem cell injections, have shown good results in the treatment of osteoarthritis symptoms, greatly increasing the patient’s quality of life, especially when combined with other therapeutic options. Non-inclusion of the latter therapies in the guidelines, and their inconsistent stance on numerous therapy options, requires larger and well-designed studies to examine the true effects of these therapies and update the existing guidelines.

Cytokine Profiling and Intra-Articular Injection of Autologous Platelet-Rich Plasma in Knee Osteoarthritis

“…Current interventions in the management of knee OA including physical and pharmacological therapies aim to relieve pain and improve physical function, but do not stop the disease progression. For that reason, in knee OA patients who are unable to tolerate oral pharmacological therapy, intra-articular injection has been suggested as an alternative therapeutic option for delaying surgical treatment [7][8][9].…”

Mesenchymal Stem Cells Based Treatment in Dental Medicine: A Narrative Review

“…Studies investigating these effects are conducted in multiple fields of medicine for the treatment of degenerative and inflammatory diseases, also including COVID-19 pneumonia and ARDS [10][11][12]. However, their path to daily clinical use is still in its early stages, mainly due to the methodological differences in the literature [13].…”

Exploiting real-world data to monitor physical activity in patients with osteoarthritis: the opportunity of digital epidemiology

“…Osteoarthritis (OA), is a degenerative disease of the articular cartilage that mainly affects older people, causing disability worldwide [ 6 ]. Current treatments include the use of non-steroidal anti-inflammatory drugs, opioid and non-opioid analgesics, intra-articular injections of steroids and hyaluronic acid, and surgical procedures [ 7 ]. However, side effects and contraindications of these treatments suggest considering adopting new non-pharmacological, regenerative, and behavioral approaches [ 8 , 9 ].…”