Published 10/3/2022

FACT SHEET: Appropriate Use Criteria (AUC) for the Management of Osteoarthritis of the Knee (Non-Arthroplasty)

ROSEMONT, Ill. (October 3, 2022)—The American Academy of Orthopaedic Surgeons approved the publication of a new set of Appropriate Use Criteria (AUC) on the Management of Osteoarthritis of the Knee (Non-Arthroplasty). AAOS AUC provide clinicians with algorithmic tools to determine the appropriateness of treatments based on a patient’s presenting indications. The treatment scenarios provided by this AUC stem from the recommendations in the Clinical Practice Guideline (CPG) issued by the AAOS in September 2021.  

Approximately 33 million Americans are affected by osteoarthritis (OA), a common condition that occurs when the cartilage that cushions and protects the ends of the bones gradually wears away. OA, also known as “wear and tear” arthritis can affect any joint in the body but is very prevalent in the knee. It commonly occurs in people who are 50 years of age or older and can be a leading cause of physical disability.

This AUC is intended to offer guidance on decision factors for adults (ages 19 years and older) who have been diagnosed by a physician with symptomatic osteoarthritis of the knee and are undergoing treatment. The AUC online tool provides clinicians algorithms on how to optimally evaluate the condition based on a patient’s various indications.

The conditions listed below are specifically not addressed in these AUC:

  1. Inflammatory disorders that are the likely cause of the knee pain;
  2. Asymptomatic patients;
  3. Growth factor or stem cell injections;
  4. Hyaluronic Acid (HA) – Lack of evidence to identify subgroups of patients for which HA is appropriate treatment;
  5. Tramadol and other narcotic medications.

The new AUC is geared to orthopaedic surgeons who evaluate patients with knee pain and mobility issues related to a diagnosis of osteoarthritis and for whom joint-replacement surgery is not indicated; however, healthcare professionals other than orthopaedic surgeons, including but not limited to adult primary care physicians, adult medicine specialists, sports medicine physicians, physical therapists, occupational therapists, physician assistants, nurse practitioners who routinely see this patient population in various practice settings may benefit from this tool. This AUC tool is not intended for use as a benefits determination document.

The AUC tool offers accepted approaches to treatment and/or diagnosis and is not intended to be a fixed protocol. Patient care and treatment should always be based on a clinician’s independent medical judgment, giving the individual patient’s specific clinical circumstances.

The full AUC for the management of osteoarthritis of the knee (non-arthroplasty) is available through AAOS’ OrthoGuidelines website and free mobile app. For more information on the development process for AAOS’ quality products, please reference the Research Resources Methodology.

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Contact AAOS Media Relations 

Deanna Killackey 


Lauren Riley