Design: This study was a systematic review of all the relevant literature available.
Methods: The initial step in this study was to gather all randomised controlled/clinical trials (RCTs) relevant to this particular topic. A computerised literature search of MEDLINE, Science Direct, MANTIS, the Cochrane Library, CINAHL, AMED, NCCAM and the World Wide Web was performed. RCTs were chosen based on certain criteria. Each study had to be published in English and included human subjects only. The search terms used were topical treatments for osteoarthritis, topical AND OA, topical therapy for osteoarthritis and treatments for OA. The RCTs which met the inclusion criteria were evaluated for methodological quality, using the Jadad point-scoring system. Trials scoring three or more points were used to draw conclusions about the most efficacious topical treatments for osteoarthritis.
Results: Twenty-eight RCTs were collected from May to October 2005. Online databases were checked monthly to ensure any added RCTs were found and not missed. Seventeen of these studies met the inclusion criteria and 16 of these gained 3 or more points (5 points was the maximum score) on the Jadad scale.
Conclusions: There is strong evidence to suggest that topical pharmacological and non-pharmacological formulations provide relief of pain and joint stiffness, and improve levels of functional disability in patients with primary knee OA. There is some evidence that suggests the number of analgesics can be reduced when topical preparations are used for symptomatic relief for OA of the knee.
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