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Table 1 Current traditional pharmacological therapies for osteoarthritis

From: Therapeutic potential of mesenchymal stem cell based therapy for osteoarthritis

Treatment modality Patient benefits Shortcomings References
Non-steroidal anti-inflammatory drugs (NSAIDs) Analgesic effects; reduction in pain, stiffness, swelling Often inadequate symptom relief; potential for liver damage in overdose; potential for ulcer and kidney disease; potential for bleeding and vascular events; can cause allergies; effectiveness is dependent upon patient compliance; will not reverse cartilage damage [48]
Physical activity/therapy Can improve flexibility, range of motion, and function of joint; can provide pain relief; strengthens muscles around the joint; targets obesity, the most important modifiable risk factor for OA Often poor patient compliance; pain/symptom relief is often not enough for patient to adhere to the regiment; will not reverse cartilage damage [912]
Opioids Provide pain relief Usefulness in the long-term is limited; Increased risk of adverse events (fractures, cardiovascular events, depression, addiction, overdose, mortality); numerous side effects; will not reverse cartilage damage [9, 1315]
Intra-articular injections Hyaluronic acid injections can provide pain relief and improved function that can last over 8 weeks; corticosteroid injections can provide effective short-term pain relief and improved function Injections must be performed in a doctor’s office; injections done more than once every 4 months can result in cartilage and joint damage and increase the risk of infection; hyaluronic acid injections show varying efficacy; neither type of injections will reverse cartilage damage [9, 1517]
Surgery Total joint arthroplasty can potentially provide permanent pain relief and improved mobility; arthroscopic irrigation and debridement can offer pain relief Many joints do not respond well to total joint arthroplasty; surgery is expensive for patients; increased risk of infection and invasive trauma; arthroscopic procedures do not provide long-term benefits [9, 15, 17, 18]