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Hip and knee osteoarthritis: guideline for the nonsurgical management of hip and knee osteoarthritis.

Latest update: July 2009. Next update: Within five years. Patient group: Patients with hip and knee osteoarthritis. Intended audience: General practitioners and other primary care health professionals involved in the management of patients with hip and knee osteoarthritis. Additional versions: A guide for referral for joint replacement mentioned in the care algorithm of this guideline is also available. Expert working group: 14 health care professionals including rheumatologists, GPs, physiotherapists, and nurses. Funded by: Australian Government Department of Health and Aging. Consultation with: Draft versions of the guidelines were made available on the web for public feedback, with over 200 personal invitations sent to known stakeholders. Approved by: NHMRC and Royal Australian College of General Practitioners. Location: Both the guidelines and the guide for referral for joint replacement are available at: http://www.racgp.org.au/guidelines/ musculoskeletaldiseases

Description: This 70 page document reviews the nonsurgical management of hip and knee OA with particular reference to the role of the general practitioner. It includes a brief review of osteoarthritis and its impact on society. Evidence-based algorithms for diagnosis and assessment, care planning and management, and a flow chart are provided, with the latter providing the levels of evidence for both non-pharmacological (eg, allied health--exercise) and pharmacological interventions. The next three pages (16-19) provide a summary of key recommendations relating to general recommendations, non-pharmacological, pharmacological interventions, and interventions not supported by current evidence. The remainder of the document provides more detailed discussion of these recommendations and the references supporting the attributed level of recommendation. Managements with some evidence to support their use include exercise therapy, multimodal physical therapy, and acupuncture. Interventions not supported by current evidence include viscosupplementation, therapeutic ultrasound, and electromagnetic fields.

Kevin Sims

Physiotherapist, Cricket Australia

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Title Annotation:Appraisal: Clinical Practice Guidelines
Author:Sims, Kevin
Publication:Australian Journal of Physiotherapy
Article Type:Report
Geographic Code:8AUST
Date:Jun 1, 2010
Words:286
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