Treatment options for osteoarthritis.

Osteoarthritis (OA) is a debilitating, degenerative disease of the articular cartilage and synovial fluid. Approximately 20 million Americans suffer from this disease for which no cure exists as yet. The primary goals of current OA therapy are centered on controlling pain; improving, preserving, or both, joint function and mobility; and improving health-related quality of life-but not on reversing the disease process. Current treatment options of OA consist of both non-pharmacological and pharmacological modalities. Non-pharmacological therapy that consists of patient education and physical/occupational therapy is a primary component of OA management, either rendered alone or in combination with pharmacological treatment. The several options for pharmacological treatment include acetaminophen, nonspecific NSAIDs, and COX-2 specific inhibitors. Many of these drugs, however, are beset with serious side effects. For patients with severe OA not responsive to medical treatment, nonsurgical interventions such as viscosupplements and injectable compounds that mimic healthy synovial fluid or surgical interventions are two likely options. The former, however, have not been shown unequivocally to be effective. Future treatment modalities for OA are geared toward reversing the disease process and may include disease-modifying drugs and gene therapy.