This is the AAOS third-edition evidence-based clinical practice guideline for nonarthroplasty management of knee osteoarthritis in adults 17 and older. It grades treatment recommendations across nonpharmacologic, pharmacologic, and less-invasive surgical options. It does not address rheumatoid or other inflammatory arthropathies.
When a patient presents with symptomatic knee OA, this guideline gives you a defensible, evidence-graded first-line algorithm. Start with the Strong recommendations: oral and topical NSAIDs, acetaminophen, exercise, weight loss, and patient education. Avoid narcotics and lateral wedge insoles outright.
The injection landscape is the high-yield testable area. Corticosteroid buys roughly 3 months of relief, hyaluronic acid is recommended against routine use (NNT of 17), and PRP remains only a Limited recommendation that performs worse in severe OA.
The surgical message is just as important. Arthroscopic lavage/debridement for primary OA does not work and is recommended against. Partial meniscectomy is appropriate only in mild-to-moderate OA with a symptomatic tear after failed conservative care, because in advanced OA the tear is a marker of degeneration rather than a fixable pain generator.
Knowing the strength label attached to each recommendation is exactly what board questions test.
This is the AAOS third-edition evidence-based clinical practice guideline for nonarthroplasty management of knee osteoarthritis in adults 17 and older. It grades treatment recommendations across nonpharmacologic, pharmacologic, and less-invasive surgical options. It does not address rheumatoid or other inflammatory arthropathies.
When a patient presents with symptomatic knee OA, this guideline gives you a defensible, evidence-graded first-line algorithm. Start with the Strong recommendations: oral and topical NSAIDs, acetaminophen, exercise, weight loss, and patient education. Avoid narcotics and lateral wedge insoles outright.
The injection landscape is the high-yield testable area. Corticosteroid buys roughly 3 months of relief, hyaluronic acid is recommended against routine use (NNT of 17), and PRP remains only a Limited recommendation that performs worse in severe OA.
The surgical message is just as important. Arthroscopic lavage/debridement for primary OA does not work and is recommended against. Partial meniscectomy is appropriate only in mild-to-moderate OA with a symptomatic tear after failed conservative care, because in advanced OA the tear is a marker of degeneration rather than a fixable pain generator.
Knowing the strength label attached to each recommendation is exactly what board questions test.