Scientists have ranked the five most effective, non-surgical treatments for knee osteoarthritis (OA).
As The Daily Mail reports, for pain reduction, cortisone injections provide the most effective short-term relief, followed by ibuprofen, platelet-rich plasma (PRP) injections, and the non-steroid anti-inflammatory drugs (NSAIDs) naproxen and celecoxib, a US study found.
Yet, naproxen is the best overall remedy to both improve joint function and minimise discomfort, the research adds.
Hyaluronic acid (HA) injections appear to be relatively ineffective at relieving pain or boosting knee function, with 12 out of 53 studies finding such therapies are no better than placebo, the study found.
The researchers believe their findings support the use of naproxen as a first-line drug-based treatment for knee OA.
Previous research also suggests naproxen causes less heart attacks and strokes than other drugs of its class.
Around 45 percent of people in the US develop OA at some point in their lives. OA is caused by the cartilage at the ends of bones breaking down over time.
Results may help patients weigh up their treatment options
Lead author Dr David Jevsevar, from the non-profit health system Dartmouth-Hitchcock, New England, said: 'Because knee OA has both a high disease burden and high treatment costs, additional prospective studies using similar outcomes, timelines, and measures of clinically important changes are needed.
'While the information in this analysis is helpful to physicians, patients also can benefit from these findings and use it with their doctors to weigh all possible treatment options.'
How the research was carried out
The researchers analysed 53 studies that examined OA treatments for at least 28 days with a minimum of 30 people per trial.
The five most effective short-term pain-relievers for knee oestoarthritis (OA) are, in order:
1) Cortisone injections
3) Platelet-rich plasma (PRP) injections
The treatments analysed included acetaminophen; ibuprofen; intra-articular (IA) or joint injections of cortisone, PRP and HA; and several NSAIDs, including diclofenac; and both oral and IA placebo.
Dr Jevsevar added: 'This is the first comprehensive mixed-comparison analysis comparing best-evidence scientific research and excluding lower-quality studies that can bias the outcomes.'
The findings were published in the Journal of the American Academy of Orthopaedic Surgeons.