The Efficacy of Total Knee Replacement as Compared to Pharmacological Agents in Adults 40-80 Years Old with Knee Osteoarthritis

Introduction: Osteoarthritis (OA) is the most common form of arthritis with the knee being the most commonly affected joint. Total knee replacement (TKR) and non-steroidal anti-inflammatory drugs (NSAIDs) are currently the main treatments but evidence of their efficacy is conflicting. This review analyzes whether TKR leads to a better patient reported quality of life (QOL) as compared to use of pharmacological agents such as NSAIDs, Glucosamine, or Chondroitin Sulfate supplementation in adults 40 to 80 years old with knee osteoarthritis. Methods: A literature search was performed through Ovid and PubMed. Six articles were selected and analyzed for their intervention technique, participant population, and publication dates utilizing specific exclusion criteria. Results: The evidence collected by all six studies within the meta-analysis show a significant improvement in pain regardless of treatment intervention. Two of the studies investigated TKR intervention comparing post-surgical care. Four of the studies looked at pharmacological intervention on knee OA with one comparing nutraceuticals to placebo, one comparing nutraceuticals with combined NSAID use, one comparing nutraceuticals with celecoxib, and one comparing a COX-1 inhibitor with a COX-2 inhibitor. Discussion: For outcome measures such as QOL, function, and stiffness there were contradictory conclusions drawn for both TKR intervention and pharmacological intervention. Some limitations include exclusion of participants with comorbidities and the lack of long-term studies. Further research is necessary to determine the best course of care. Conclusion: Although both surgical and non-surgical intervention show positive outcomes, there is conflicting evidence therefore the best course of care cannot be determined. No recommendation can be made on the most efficacious plan of care for knee OA, thus further research is needed