Nonsurgical management options for OA include analgesics and anti-inflammatory drugs, weight management, exercise, and physical therapy or a combination of these strategies (such as medication plus exercise). When medication and exercise or physical therapy are not enough to decrease pain and improve quality of life, joint surgery is another option. Each management strategy has tradeoffs. For example, persons with OA are twice as likely as those without to develop peptic ulcers (relative risk, 2.49 [95% CI, 1.37 to 4.51]) and renal disease (relative risk, 2.10 [CI, 1.10 to 4.01]), which are probably associated with high use of anti-inflammatory medications (10). However, evidence is limited on the relative benefits and harms of therapies within each category (medication, physical therapy and exercise, weight loss, or surgery) and there are few direct comparisons of effectiveness, in terms of patient-centered outcomes, among categories or combinations of categories.