Table 3 Inclusion/exclusion criteria for the risks and harms associated with commonly used treatment for knee osteoarthritis literature search

Publication type

Peer-reviewed original research articles, systematic reviews and meta-analysis only

Non-peer-reviewed articles, newspapers, opinion pieces, editorials, commentaries and letters to the editor. Conference proceedings/abstracts. Book chapters. Downs and Black [7] quality score > 13

The aim of this review was to investigate the risks and harms associated with commonly used treatment for knee osteoarthritis. For reasons of practicality, it was deemed acceptable to include only studies published in peer-reviewed journals.

Language

English language

Non-English

For reasons of practicality, it was deemed acceptable to include only studies published in English.

Population

Knee osteoarthritis in patients 18-years and older

Knee osteoarthritis in patients 17-years and younger

Average age of knee osteoarthritis diagnosis is 55-years and typically people live about 30-years with the disease.

Intervention

Operative and non-operative management of knee osteoarthritis treatments treatments listed in the Australian Clinical Care Standard [5] and/or Therapeutic Guidelines: Rheumatology [6] and specifically addressed safety of the treatments;

Operative and non-operative management of knee osteoarthritis not listed in the Australian Clinical Care Standard [5] and/or Therapeutic Guidelines: Rheumatology [6].

Commonly accepted treatments were sought out and the authors decided upon treatments listed in Australian Clinical Care Standard [5] and/or Therapeutic Guidelines: Rheumatology [6].

Outcome measures

Studies specifically addressed safety of the treatments with ≥12 months of follow-up. Long-term effect of a treatment could be either: (1) Positive OR negative effect of index treatment vs comparison treatment in any trial persisting at ≥12 months; or (2) Positive OR negative effect of index treatment vs comparison treatment in any trial showing significant change in any objective disease indicator (e.g. cartilage thickness on magnetic resonance imaging (MRI) or X-ray) at ≥12 months; or (3) Effect of index treatment showing significantly increased OR reduced risk of progression to TKA; or (4) Significant increase in side-effect or harm related to treatment with a potential for ongoing harm from this condition to persist beyond 12 months.

Short-term effects of osteoarthritis treatments. Side effects and adverse effects were not included in this review as they are typically short-term issues (e.g. allergic rash, post-procedure soreness).

The primary outcomes of interest for this review was to describe the long-term effects of the knee osteoarthritis treatments. As there is no curative treatment for OA currently, treatments are aimed at reducing pain and improving function. The prevalence of osteoarthritis increases with age, particularly after the age of 55-years such that the average person lives 30-years with knee OA. Therefore, it is important to appraise the long-term effects of knee OA treatment.