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Editorials |

Knee Pain and Osteoarthritis: Lessons Learned and Lessons to Be Learned

Allan C. Gelber, MD, MPH, PhD
[+] Article, Author, and Disclosure Information

From Johns Hopkins University School of Medicine, Baltimore, MD 21224.

Potential Conflicts of Interest: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-2581.

Requests for Single Reprints: Allan C. Gelber, MD, MPH, PhD, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Mason F. Lord Building, Center Tower, Suite 4100, Baltimore, MD 21224; e-mail, agelber@jhmi.edu.

Ann Intern Med. 2011;155(11):786-787. doi:10.7326/0003-4819-155-11-201112060-00011
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In this issue, Nguyen and colleagues show that the prevalence of knee pain, but not of radiographically defined knee osteoarthritis, has increased over recent years, a period during which knee replacement surgery has also increased. The editorialist asserts that these findings call health services researchers and treating clinicians to action, to investigate possible secular trends in the radiographic severity or demographic profile of patients who are referred for and those who undergo knee replacement surgery.

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Possible explanation for increasing prevalence of osteoarthritis.
Posted on December 12, 2011
Clive L., Sinoff, Physician
Conflict of Interest: None Declared

The article by Nguyen et al describes the inexorable rise in the prevalence of osteoarthritis of the knee. Ross Hauser, M.D., in two extensive reviews, convincingly shows the correlation of the prevalence of osteoarthritis with the use of anti-inflammatory agents, both NSAIDs and corticosteroid injections. He also provides strong basic science and animal experimental evidence of the probable mechanism to strengthen his thesis. In view of such evidence, the question arises why the "standard" treatment for musculo-skeletal conditions should so commonly involve these anti-inflammatory agents.


1. Hauser RA. The deterioration of articular cartilage in osteoarthritis by corticosteroid injections. J Prolotherapy 2009;1:107-123.

2. Hauser RA. The acceleration of articular cartilage degeneration in osteoarthritis by nonsteroidal anti-inflammatory drugs. J Prolotherapy 2010;2:305-322.

Conflict of Interest:

None declared

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