Guideline recommendations

All major clinical practice guidelines for knee osteoarthritis recommend core treatments of:

  • Patient education, lifestyle modification and self-management
  • Exercise therapy and physical activity
  • Weight management (as appropriate)


Beyond this, there are many instances of contradictory recommendations for what constitutes second line treatment. For example, some recommend the use of paracetomol or manual therapies, whereas others do not. This, alongside the general paucity of recommendations to help clinicians ‘implement’ their recommendations, means that care being provided to people with knee osteoarthritis often varies.


To access the latest guidelines, click the respective links below.

ACR (American college of rheumatology) – 2019

EULAR (European alliance of associations for rheumatology) – 2013

National institute of health and care excellence (NICE) – 2014 (updated 2020)

OARSI (Osteoarthritis research society international) – 2019

RACGP (Royal Australian college of general practitioners) – 2018


This file collates the education recommendations from the ACR, EULAR, NICE and OARSI guidelines.


Expert opinion research articles offer further advice that may be useful for people with knee osteoarthritis. Below are a few key articles that may be useful about:

Three steps to changing the narrative of knee osteoarthritis


Exercise and physical activity

Exercise for weight management