Recommendations for osteoarthritis

Abstract

Osteoarthritis (OA) represents one of the most important clinical situation characterized by chronic pain (CP), huge number of patients worldwide and large amount of burden for each national health systems. Moreover, OA is now considered as a syndrome in terms of each articular localization; on the other hands the cartilage remodelling is characterized by an imbalance between degradation and synthesis due to the impact of subchondral bone citokines production. OA presents mechanic CP, and inflammatory acute pain in the period of inflammatory flare. The American College of Rheumatology published the “2012 recommendations for the therapy of OA”: NSAIDs, acetaminophen, opioids, intra-articular steroids, as well as intra-articular viscosupplementation are the cornerstones of the pharmacological recommendations, while weight management and exercises are the most important suggestions for non-pharmacological treatments. The American Academy of Orthopeadic Surgeons published in the 2015 the surgery criteria for OA: both conservative and pharmacological treatments come first the surgical approaches. It is very important to consider that an early diagnosis of OA and an accurate stadiation of the disease can lead to the early start of a focused therapy, the reduction of evolution towards chronicity, progression, and disability, with a consequent reduction of pain and burden, and, finally, the increasing of quality of life.