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Critical Reviews™ in Physical and Rehabilitation Medicine
SJR: 0.117 SNIP: 0.228 CiteScore™: 0.17

ISSN Print: 0896-2960
ISSN Online: 2162-6553

Critical Reviews™ in Physical and Rehabilitation Medicine

DOI: 10.1615/CritRevPhysRehabilMed.2013007630
pages 251-264

Osteoarthritis: A Critical Review

Kentaro Onishi
Department of Physical Medicine and Rehabilitation, University of California—Irvine, Orange, California
Amol Utturkar
Department of Physical Medicine and Rehabilitation, University of California—Irvine, Orange, California
Eric Y. Chang
Department of Physical Medicine and Rehabilitation, University of California, Irvine, Orange, California
Richard Panush
Department of Medicine, University of Southern California, Keck School of Medicine, Los Angeles, California
Justin Hata
Department of Anesthesiology & Perioperative Care, Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, University of California, Irvine, Orange, California 92697; Loma Linda Pain Management, 11406 Loma Linda Drive, Loma Linda, CA 92354
Danielle Perret-Karimi
Department of Anesthesiology & Perioperative Care, Department of Physical Medicine and Rehabilitation, University of California, Irvine, Irvine, CA 92697

ABSTRACT

Patients with osteoarthritis (OA) are faced with a barrage of treatment options, from recommendations from friends and social media to medications prescribed by the primary care physician. The purpose of this article is to critically review current approaches to generalized or monoarticular OA based on available evidence and to illustrate multidisciplinary and multimodal treatment strategies for the management of OA. Treatment options assessed for efficacy include patient education; oral and topical pharmacological agents; complementary and alternative medicine; surgery; manual medicine; acupuncture; interventional procedures (corticosteroid injection, viscosupplementation, and pulsed radiofrequency); bracing; assistive devices; physical therapy; and physical modalities. Multidisciplinary and multimodal treatment strategies combined with early detection and prevention strategies provide the best benefit to patients.
This review also illustrates that traditional and alternative modalities of treatment can be both synergistic and beneficial. Physicians should be aware of the variety of tools available for the management of OA and the associated symptoms. Those healthcare providers who can best individualize treatment plans for specific patients and inspire their patients to embrace healthy lifestyle modifications will achieve the best results.