Osteoarthritis

Leukocyte-rich versus leukocyte-poor platelet-rich plasma and hyaluronic acid for knee osteoarthritis: a systematic review and network meta-analysis.

Xu B, Huang X, Su X, Fu Y, Feng S, Zhou Y · Journal of orthopaedic surgery and research · 2026 · n=254

To compare the comparative efficacy and safety of leukocyte-rich platelet-rich plasma (L-PRP), leukocyte-poor platelet-rich plasma (LP-PRP), hyaluronic acid (HA), and placebo for the treatment of knee osteoarthritis (KOA). Systematic review and network meta-analysis of randomized controlled trials (RCTs). A comprehensive search of PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science was conducted from inception to October 2025, without language restrictions. We included RCTs that compared at least two of the following interventions in patients with KOA: L-PRP, LP-PRP, HA, or placebo. The primary outcome was functional improvement measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes were pain reduction and the incidence of short-term adverse events. Twenty-one RCTs, comprising 2,254 patients, were included. The network meta-analysis demonstrated that for functional improvement at 6-12 month

Comparison of weight loss interventions in overweight and obese adults with knee osteoarthritis: A systematic review and network meta-analysis of randomized trials.

Shahid A, Thirumaran AJ, Christensen R, Venkatesha V, Henriksen M, Bowden JL · Osteoarthritis and cartilage · 2025 · n=2800

To ascertain the comparative effectiveness of weight-loss strategies for osteoarthritis (OA) to develop rational treatment algorithms aimed at improving OA-related symptoms in overweight/obese individuals. Medline, Embase, CINAHL, Scopus, and Web of Science were searched from inception to June 2023 for observational studies and randomized trials. Network meta-analyses were performed using a frequentist approach. Effect sizes for pain and function were computed as standardized mean differences, while change in body weight was computed as mean differences. 13 RCTs on knee OA (KOA) (2800 participants) with 7 interventions: diet (D); exercise (E); diet and exercise (DE); pharmacological (L); psychological (P); psychological, diet, and exercise (PDE); and Mediterranean diets (M) were networked. For weight change (kg), all interventions significantly outperformed control comparators, with effect sizes ranging from -11.2 (95% CI, -16.0, -6.5 kg) for the most effective approach (PDE) to

Effect of collagen supplementation on knee osteoarthritis: an updated systematic review and meta-analysis of randomised controlled trials.

Simental-Mendía M, Ortega-Mata D, Acosta-Olivo CA, Simental-Mendía LE, Peña-Martínez VM, Vilchez-Cavazos F · Clinical and experimental rheumatology · 2025 · n=870

To perform a systematic review and meta-analysis to assess the clinical efficacy of collagen-based supplements on knee osteoarthritis (OA) symptoms. Until October 2023, we conducted searches on the MEDLINE, EMBASE, Web of Science, and Scopus databases to identify randomised controlled trials (RCTs) that reported the effects of oral collagen-based supplements on knee OA. Quantitative data from outcomes were pooled using a random- or fixed-effects model (depending on inter-study variability) and the generic inverse variance method. The Cochrane Risk of Bias 2.0 tool was employed to assess the risk of bias. This systematic review incorporated information of 870 participants included from 11 RCTs, with 451 allocated to the collagen supplementation group and 419 to the placebo group. The meta-analysis revealed an overall significant improvement of both function [MD, -6.46 (95% CI -9.52, -3.40); I2=75%; p=0.00001] and pain scores [MD, -13.63 (95% CI -20.67, -6.58); I2=88%; p=0.00001], favo

Osteoarthritis and the Mediterranean Diet: A Systematic Review.

Morales-Ivorra I, Romera-Baures M, Roman-Viñas B, Serra-Majem L · Nutrients · 2018

Osteoarthritis (OA) affects 240 million people globally. Few studies have examined the links between osteoarthritis and the Mediterranean diet (MD). The aim of this paper was to systematically review and analyze the epidemiological evidence in humans on the MD and its association with OA. A systematic search of EMBASE identified three studies that explored the association between MD and OA. Two of them were cross-sectional and the third one was a 16-week randomized clinical trial. Prisma declaration was followed to carry out this review. These studies described a positive association between a higher adherence to a MD and the quality of life of participants suffering OA. The prevalence of OA was lower in participants with a higher adherence to a Mediterranean diet. Biomarkers of inflammation and cartilage degradation related to OA were also analyzed and significant differences were detected only for IL1-α, which decreased in the MD group. Exploring the relationship between MD and

Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee

ACR

This guideline provides recommendations for the management of osteoarthritis affecting the hand, hip, and knee, covering pharmacologic and nonpharmacologic therapies.

Acupuncture in patients with osteoarthritis of the knee: a randomised trial.

Witt C, Brinkhaus B, Jena S, Linde K, Streng A, Wagenpfeil S · Lancet (London, England) · 2005 · n=150

Acupuncture is widely used by patients with chronic pain although there is little evidence of its effectiveness. We investigated the efficacy of acupuncture compared with minimal acupuncture and with no acupuncture in patients with osteoarthritis of the knee. Patients with chronic osteoarthritis of the knee (Kellgren grade < or =2) were randomly assigned to acupuncture (n=150), minimal acupuncture (superficial needling at non-acupuncture points; n=76), or a waiting list control (n=74). Specialised physicians, in 28 outpatient centres, administered acupuncture and minimal acupuncture in 12 sessions over 8 weeks. Patients completed standard questionnaires at baseline and after 8 weeks, 26 weeks, and 52 weeks. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index at the end of week 8 (adjusted for baseline score). All main analyses were by intention to treat. 294 patients were enrolled from March 6, 2002, to January 17, 2003; eight patient

Comparative Effectiveness of Nutritional Supplements in the Treatment of Knee Osteoarthritis: A Network Meta-Analysis.

Zhang Y, Gui Y, Adams R, Farragher J, Itsiopoulos C, Bow K · Nutrients · 2025 · n=4599

Background: Knee osteoarthritis (KOA) is a prevalent degenerative joint disease that can greatly affect quality of life in middle-aged and elderly individuals. Nutritional supplements are increasingly used for KOA due to their low risk, but direct comparative evidence on their efficacy and safety remains scarce. This study aimed to systematically compare the effectiveness and safety of seven common nutritional supplements for KOA. Methods: A systematic review and network meta-analysis were conducted following PRISMA guidelines. Embase, PubMed, and the Cochrane Library were searched through December 2024 for randomized controlled trials (RCTs) evaluating use of eggshell membrane, vitamin D, Boswellia, curcumin, ginger, krill oil, or collagen, versus placebo, in adults with KOA. Primary outcomes included changes in scores for WOMAC pain, stiffness and function, and pain visual analog scale (VAS). Adverse events were also assessed. Bayesian network meta-analyses estimated ranking probabil

Acupuncture: ancient remedy or modern placebo?

Morawik I, Turżańska K, Jabłoński M · Wiadomosci lekarskie (Warsaw, Poland : 1960) · 2025

Acupuncture as an alternative method of pain treatment was created in China 3000 years ago. It still has many supporters. For years, it has been used in many countries to relieve labor pains, postoperative pains, pains caused by osteoarthritis, toothaches, and headaches. The World Health Organization (WHO) has significantly expanded the indications for the use of acupuncture. The primary aim of this article is to critically evaluate whether acupuncture is a scientifically validated therapeutic intervention or primarily a placebo effect? Material and methods: The material and methods section of this article involves a comprehensive review of existing literature, including systematic reviews, randomized controlled trials (RCTs), and meta-analyses on acupuncture. The review also includes observational data on patient outcomes, potential risks, and reported complications. The effectiveness of acupuncture has been extensively studied, with varying levels of scientific support for different

Diet in Knee Osteoarthritis-Myths and Facts.

Kasprzyk N, Nandy S, Grygiel-Górniak B · Nutrients · 2025

Knee osteoarthritis (OA) is a common degenerative joint disease affecting global health. Its increasing prevalence, particularly among aging populations, remains a leading cause of disability. Besides conventional pharmacological and surgical treatments, dietary interventions are promising strategies to alleviate OA symptoms and progression. Unfortunately, scientific evidence does not support many commonly used, misleading ideas about nutrition in knee OA. Recent data highlight the detrimental effects of high-carbohydrate and high-fat diets, particularly those rich in refined sugars and saturated fats, which exacerbate systemic inflammation and contribute to cartilage degradation. Conversely, diets rich in omega-3 fatty acids, polyphenols, and dietary fiber have shown anti-inflammatory and chondroprotective properties. A Mediterranean diet rich in these nutrients effectively prevents the development of OA and its comorbidities, including obesity and cardiovascular disease. The role of

Osteoarthritis

NHS

The NHS website offers detailed information about osteoarthritis, including its symptoms, causes, diagnosis, and various treatment options available in the UK.

Musculoskeletal conditions

WHO

The WHO provides general information and fact sheets on musculoskeletal conditions, which include osteoarthritis, highlighting their global burden and impact.

Prospective Randomized-Controlled Two-Arm Study of "Blind" vs. Fluoroscopy-Guided Steroid Injections for Knee Osteoarthritis

NCT02104726 · WITHDRAWN · WITHDRAWN

To compare relative efficacy of intraarticular steroid injection using anatomic landmarks vs. fluoroscopy guided technique in decreasing knee osteoarthritis pain 1 month after the procedure.

Cormet Hip Resurfacing System Post-PMA Study Group (New Enrollment)

n=147 · NCT00722007 · COMPLETED · COMPLETED

The primary objective of this study is to evaluate the performance of the Cormet Hip Resurfacing implant system in the post-approval environment.

Deciphering the Role of the Microbiota in Osteoarthritis for Improving Therapy

n=40 · NCT03985709 · UNKNOWN · UNKNOWN

The gut microbiome appears to be a significant contributor to musculoskeletal health and disease. Microbiome composition and its functional implications have been associated with prevention of bone loss and/or reducing fracture risk. Genetic background, gender, dietary intake, and social factors are also important factors which contribute to the musculoskeletal health, as well as to the normal balance of intestinal microbiota. The link between gut microbiota and joint inflammation in murine models of arthritis has been established, and it is now receiving increasing attention in human studies. Recent papers have demonstrated substantial alterations in the gut microbiota in patients with rheumatoid arthritis (RA) and osteoarthritis (OA). These alterations resemble those established in systemic inflammatory conditions (inflammatory bowel disease, spondyloarthritides, psoriasis), which include decreased microbial diversity and lower abundances of bacteria belonging to the Firmicutes phylum that are known to have immunoregulatory properties.These new findings open important future horizons both for understanding disease pathophysiology and for developing novel biomarkers and treatment strategies. Further investigation into the mechanisms linking changes in the microbiome to alterations in bones and joints is necessary. Next Generation Sequencing, metatranscriptomic analysis, and metabolomic approaches may provide yet-greater insight and help further understand these mechanisms. To investigate gut microbiota change will be associated with the sintoms of knee and / or hip OA in italian patients.

Cochrane Reviews on Osteoarthritis

Cochrane

The Cochrane Library provides high-quality, independent evidence to inform healthcare decision-making, including systematic reviews on various interventions and treatments for osteoarthritis.

TRIP Database: Osteoarthritis

TRIP Database

TRIP is a clinical search engine designed to allow users to quickly and easily find high-quality research evidence to support their practice, including systematic reviews, guidelines, and other evidence for osteoarthritis.