The full content of Annals is available to subscribers

Subscribe/Learn More  >
Reviews |

Published Trials of Nonmedicinal and Noninvasive Therapies for Hip and Knee Osteoarthritis

David W. Puett, MD; and Marie R. Griffin, MD, MPH
[+] Article, Author, and Disclosure Information

From Vanderbilt University, Nashville, Tennessee. Requests for Reprints: Marie R. Griffin, MD, MPH, Department of Preventive Medicine, Vanderbilt University, A-1124 Medical Center North, Nashville, TN 37232-2637. Acknowledgments: The authors thank Cindy Naron for help in preparing the manuscript. Grant Support: In part by the Food and Drug Administration (FD-U-000073) and the Agency for Health Policy and Research (1 R01AG10566-01AZ).

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1994;121(2):133-140. doi:10.7326/0003-4819-121-2-199407150-00010
Text Size: A A A

Purpose: To review the efficacy of nonmedicinal, noninvasive therapies in hip and knee osteoarthritis.

Data Sources: Search of English-language literature from 1966 through 1993 using MEDLINE by cross-referencing “osteoarthritis” (therapy subheadings) with “controlled trial,” “comparative study,” or “trial(s)”.

Study Selection: Fifteen controlled trials of diathermy (deep heat), exercise, acupuncture, transcutaneous electrical nerve stimulation, topically applied capsaicin, low-energy laser, and pulsed electromagnetic fields were found. No experimental studies of superficial heat and cold, orthotic devices, vibration, or weight loss were identified.

Results: Exercise reduces pain and improves function in patients with osteoarthritis of the knee. No support exists in the literature for pre-exercise ultrasound treatment. Single, well-designed studies suggest that topically applied capsaicin and laser treatment reduce pain associated with knee osteoarthritis. Data on the other three therapies were sparse (transcutaneous electrical nerve stimulation, pulsed electromagnetic fields) or inconsistent (acupuncture).

Conclusions: More data are needed to determine the optimal exercise regimen for treating knee osteoarthritis and to evaluate the role of topical capsaicin, laser therapy, acupuncture, transcutaneous electrical nerve stimulation, and pulsed electromagnetic fields. No data specifically address the role of any of these therapies in hip osteoarthritis.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.