Comparative effectiveness of different drugs used for knee osteoarthritis: a systematic 

review of the literature and meta-analysis

In January 2015, a very interesting article was published  by Dr. Bannuru and associates on the 

effectiveness of drug treatments in primary osteoarthritis of the knee, through meta-analysis 

(review of the most important articles published in recent years on this subject) , which compares 

the relative effects of all these drugs on osteoarthritis of the knee.

After a systematic search, randomized studies in adults with knee osteoarthritis comparing two or 

more of the following treatments were included: Paracetamol, Diclofenac, Ibuprofen, Naproxen, 

Celecoxib, intra-articular corticosteroids (infiltrations), intra-articular Hyaluronic Acid (infiltrations),

oral placebo and placebo via intraarticular infiltration.

137 studies were carried out on 33,243 participants.

For the pain, all the evaluated treatments were better than oral placebo. Of these, the most 

effective treatment was intraarticular Hyaluronic Acid, and the least effective, oral Paracetamol.

For the mobility functions (ability to walk, climb stairs, etc.) all treatments, except intraarticular 

corticosteroids were superior to oral placebo.

To sum up, intraarticular treatments were superior to NSAIDs. All treatments, except Paracetamol, 

showed clinically significant improvement in pain and functions of patients. The most effective 

treatment was intraarticular Hyaluronic Acid.

Reference : Bannuru RR, CH Schmid, Kent DM, et al.
Intern Med 2015 Jan. 6; 162 (1): 46-54. | January 6, 2015

Figure. MRI scan showing knee medial meniscus tear and incipient degenerative changes in a 

57-year-old male.