Mrs. Katson 64-year-old obese woman with bilateral knee osteoahritis. She describes pain most days and limiting pain at least 2 days per week. She has tried activity modification (walking less) without success. All of the following therapies have been shown to be efficacious EXCEPT:

1. Recent guidelines Does not recommend the use of glucosamine or chondroitin for OA. 2. Glucocoicoid injections are efficacious in OA, but response is variable. Glucocoicoid injections are useful to get patients over acute flares of pain and may be especially indicated if the patient has coexistent OA and crystal deposition disease. 3. Acetaminophen (paracetamol) is the initial analgesic of choice for patients with OA in knees, hips, or hands. 4. NSAIDs are the most popular drugs to treat osteoahritic pain. They can be administered either topically or orally. 5. For failed medical treatment modalities, with limitations of physical function that compromise the quality of life, the patient should be referred for total knee or hip ahroplasty.