Review reveals new treatment approaches for osteoarthritis

A multidisciplinary group of scientists has declared that osteoarthritis, the most common form of arthritis, is "surprisingly complex," but has outlined a number of new approaches to its understanding, prevention and treatment.

The report, a review by 28 researchers at 17 academic and government institutions, cites over 250 published articles and is presented in two parts in the Annals of Internal Medicine.

The disease, according to the review, can result from an inherited predisposition to OA combined with a joint injury. A healthy lifestyle helps - exercise can lessen disability if OA has developed. Strengthening the thigh muscles can reduce the risk of OA of the knee, as can losing weight. For people with the disease, a combination of treatment approaches, including new medications and patient education, is effective.

The review points out that in the United States, about 6% of adults over 30 have OA of the knee and about 3% have OA of the hip. The disease is responsible for more trouble walking and stair climbing than any other disease, and it is the most common indication for total joint replacement of the hip and knee. Before age 50, the prevalence of OA in most joints is higher in men than in women. After this age, more women are affected by OA of the hand, foot and knee. The occurrence of the disease increases with age, rising two- to 10-fold in people from 30 to 65 years of age.

The report covers risk factors, such as obesity and joint injury, and treatments ranging from established and new medications, exercise, and patient education to surgery when other treatments do not work. It also discusses new areas of research, such as easily measured disease indicators known as biomarkers, as well as engineering of new cartilage.

"This review shows that arthritis research is a vibrant area, yielding new means of preventing the disease and slowing its progression, as well as new and effective combinations of drug and behavioral treatments," said Dr. Katz, NIAMS director. "People with osteoarthritis and those at risk for the disease should be encouraged that there is much that they and their doctors can do about it." PR