Introduction:

Osteoarthritis (OA) of knee is the most common type of OA. It is a multifactorial disorder where pain is the most important clinical feature. Analgesic treatment in knee OA usually begins with acetaminophen and NSAIDs. Nonsurgical interventional indicated on nonsurgical symptomatic knee OA unresponsive to analgesic and anti-inflammatory oral and topical treatment, as well as knee osteoarthritis in surgery, when surgery is contraindicated or inadvisable.

Objectives:

A critical review of the current evidence for the following therapies intraarticular (IA): corticosteroids, hyaluronic acid (HA), ozone, platelet-rich plasma (PRP), botulinum toxin and RF geniculate nerves.

Methodology:

A search and no systematic review of individual articles, systematic reviews, meta-analysis was performed.

Results and conclusions:

IA steroids are effective, especially in those with greater radiographic commitment, with a level of evidence 1B. The PRP and AH, are useful in patients with mild to moderate knee osteoarthritis but not in severe knee osteoarthritis, with a longer duration of effect for the PRP. In severe degrees of gonarthrosis (Grades III-IV), the most suitable therapy is the RF geniculate nerves. Botulinum toxin, is superior to IA steroids with adequate response in different degrees of arthrosis, even when other therapies have not achieved adequate response. All therapies have been revised effective pain relief in knee osteoarthritis. However, there is great controversy over the degree of recommendation for each of the therapies, this because of the great variability in the phenotypes of patients included in the different studies, limiting generalizability of the results and hinders the approach of patients.

        · resumen en Español     · texto en Español     · Español ( pdf )