2013 Guidelines for the Treatment of Osteoarthritis of the Knee (AAOS)

  For patients with symptomatic knee osteoarthritis
  I. Conservative treatment
  1. Participation in self-management programs, strength training, low-intensity aerobic exercise, and neuromuscular training; participation in physical activity consistent with national guidelines is recommended.
  2. If BMI >= 25, weight loss is recommended.
  3. Acupuncture therapy is not recommended
  3. Neither favor nor oppose the use of physical therapy
  3. Neither favor nor oppose manipulative therapy
  4.Neither for nor against the use of valgus stress brace
  5.The use of lateral wedge insoles is not recommended
  6.The use of glucosamine and chondroitin is not recommended
  Second, drug treatment
  7.We recommend oral or local use of NSAIDs or tramadol
  7. Neither for nor against the use of acetaminophen, opioids and other analgesic patches
  Operative intervention therapy
  8. Neither for nor against the use of joint cavity injections of glucocorticoids
  9. Do not recommend the use of hyaluronic acid
  10.Neither for nor against the use of joint cavity injection of growth factors/ or platelet-rich plasma
  11.Do not recommend the use of syringe irrigation treatment
  IV. Surgical treatment
  12.The use of arthroscopic lavage/ or cleanup is not recommended
  13.For patients with combined meniscal rupture, arthroscopic partial meniscectomy is neither favored nor opposed
  14, In patients with symptomatic medial compartment knee osteoarthritis, clinicians may perform a proximal tibial valgus osteotomy
  15, In patients with symptomatic medial compartment knee osteoarthritis, the use of a free-floating spacer device is not recommended due to lack of credible evidence.