Osteoarthritis guideline registry¶

Last checked: 2026-08-31

Scope and status rules¶

This registry catalogs documents; synthesis is in wiki/guidelines.md. “Current” means no explicit replacement was identified on the issuing body’s site or in the retrieved record on the check date; it does not guarantee that every recommendation reflects the newest trial. PubMed-indexed documents were fetched live by PMID. Official web documents were opened or returned from the issuing body's site on the access date.

Master table¶

Body	Year	Region	Scope	Citation	Status
NICE	2022	England / UK relevance	Diagnosis and management, adults	NG226 (official page, accessed 2026-08-30)	current; supersedes CG177 (2014)
ACR / Arthritis Foundation	2019 (published 2020)	USA	Hand, hip and knee, comprehensive nonsurgical	Kolasinski et al., PMID 31908149	current; supersedes ACR 2012
OARSI	2019	International	Knee, hip and polyarticular nonsurgical care	Bannuru et al., PMID 31278997; official OARSI page, accessed 2026-08-30	current OARSI comprehensive nonsurgical document
AAOS	2021 (summary 2022)	USA	Knee OA, nonarthroplasty	Brophy et al., PMID 35383651; official AAOS page, accessed 2026-08-30	current; supersedes 2013 second edition
AAOS	2022	USA	Surgical management of knee OA	official AAOS CPG catalog, accessed 2026-08-30; prior evidence-based document PMID 27355287	current catalog entry; verify full-manuscript review date
EULAR	2023 update (published 2024)	Europe	Non-pharmacological core management, hip and knee	Moseng et al., PMID 38212040	current; supersedes Fernandes 2013
EULAR	2013	Europe	Non-pharmacological core management, hip and knee	Fernandes et al., PMID 23595142	superseded by → EULAR 2023 update (PMID 38212040)
EULAR	2018 (published 2019)	Europe	Hand OA management	Kloppenburg et al., PMID 30154087	current; supersedes EULAR 2007
EULAR	2021	Europe	Intra-articular therapies across arthropathies	Uson et al., PMID 34035002	current adjunct, not an OA-comprehensive guideline
EULAR	2017	Europe	Imaging in peripheral-joint OA	Sakellariou et al., PMID 28389554	current adjunct
RACGP	2018	Australia	Knee and hip OA before joint replacement	second-edition PDF, accessed 2026-08-30	current official page found; supersedes 2009 edition
ESCEO	2019	Europe / international expert algorithm	Stepwise knee OA pharmacologic algorithm	Bruyère et al., PMID 31126594; Central-European endorsement, PMID 31129712	current version found; GRADE-informed consensus algorithm rather than national CPG
French Society of Rheumatology + Physical and Rehabilitation Medicine	2024	France	Nonpharmacologic knee OA	Pers et al., PMID 39490291	current
French societies	2026	France	Hand OA	Courties et al., PMID 41183591	current as indexed in the 2026-08-30 audit search
Turkish League Against Rheumatism	2020	Türkiye	Hand OA	Ayhan et al., PMID 33458653	current document found
Italian Society for Rheumatology	2013	Italy	Hand OA	Manara et al., PMID 24192562	current status uncertain; watch for replacement
Royal Dutch Society for Physical Therapy	2020	Netherlands	Physical therapy for hip/knee OA	KNGF guideline paper, PMID 32643252	current paper found; supersedes earlier physiotherapy guidance
Mexican national guideline implementation target	2008	Mexico	Hip/knee OA primary care	Implementation study identifying the CPG, PMID 24909101	underlying guideline likely superseded; verify official archive
ACR	2012	USA	Hand, hip and knee nonsurgical treatment	Hochberg et al., PMID 22563589	superseded by → ACR/AF 2019
OARSI	2014	International	Knee OA nonsurgical care	McAlindon et al., PMID 24462672	superseded by → OARSI 2019
AAOS	2013	USA	Knee OA nonarthroplasty	Jevsevar, PMID 23996988	superseded by → AAOS 2021 third edition
EULAR	2007	Europe	Hand OA management	Zhang et al., PMID 17046965	superseded by → EULAR 2018 update
EULAR	2009	Europe	Hand OA diagnosis	Zhang et al., PMID 18250111	diagnostic document; not replaced by the management update
Dutch multidisciplinary guideline	2007/2008	Netherlands	Hip/knee OA diagnosis and treatment	PMID 19818192	superseded/archival; confirm chain with issuing body

Current guideline profiles¶

NICE NG226 (2022)¶

Case definition: clinical diagnosis without routine imaging at age ≥45 years with activity-related pain and no morning stiffness or stiffness ≤30 minutes; image atypical presentations (official NG226 page, accessed 2026-08-30).
Core care: tailored therapeutic exercise; weight management when relevant; information and support. NICE states that 10% weight loss is likely to confer more benefit than 5%.
Medicines: offer topical NSAID for knee OA; consider oral NSAID with toxicity assessment and gastroprotection. Do not routinely offer paracetamol or weak opioids; do not offer strong opioids or glucosamine.
Injections: do not offer intra-articular hyaluronan; corticosteroid may be considered with an explicit 2–10-week relief expectation.
Surgery: refer based on quality-of-life impact and failure/unsuitability of nonsurgical care; do not exclude solely because of age, sex/gender, smoking, comorbidity or BMI.
Supersession: explicitly updates and replaces CG177 (2014) on the official overview page.

ACR/Arthritis Foundation (2019)¶

Systematic review plus GRADE and a multidisciplinary panel including patients (Kolasinski 2020, PMID 31908149).
Strong recommendations include exercise, weight loss for overweight/obese knee or hip OA, self-management, tai chi, cane, selected orthoses/bracing, topical NSAID for knee, oral NSAIDs and knee intra-articular glucocorticoid.
Conditional options include CBT, yoga, acupuncture, radiofrequency ablation, acetaminophen, duloxetine and tramadol.
Conditional recommendation against hyaluronic acid at knee and strong against at hip is a central disagreement with more permissive algorithms.

OARSI (2019)¶

Patient-focused recommendations stratified by knee-only, hip, or polyarticular disease and comorbidity (Bannuru 2019, PMID 31278997).
Education, structured land exercise and dietary weight management are core treatments for knee OA; topical NSAIDs are strongly recommended for knee OA.
Oral NSAID selection is stratified by gastrointestinal and cardiovascular comorbidity and frailty.
The OARSI official page identifies this as the 2019 update to earlier guidance (accessed 2026-08-30).

AAOS knee nonarthroplasty, third edition (2021)¶

Applies to adults with diagnosed knee OA and covers nonpharmacologic, pharmacologic and procedures less invasive than replacement (official AAOS page, accessed 2026-08-30).
The PubMed summary is Brophy et al. 2022 (PMID 35383651).
The official page states that the third edition replaces the 2013 second edition.
Orthopedic scope and evidence thresholds differ from rheumatology panels, particularly around injections and arthroscopy.

EULAR hand OA (2018 update)¶

Prioritizes education, assistive devices, exercises and orthoses with individualized pharmacologic care (Kloppenburg 2019, PMID 30154087).
Topical treatments are favored over systemic treatments for safety.
EULAR 2007 management guidance (PMID 17046965) is the explicit predecessor.
The evidence review informing the update is separately indexed (Kroon 2018, PMID 30402266).

RACGP knee and hip OA (2018)¶

Primary-care guideline covering adults with symptomatic hip/knee OA until joint-replacement referral.
The official PDF states that it is the second edition and updates 2009 nonsurgical guidance (accessed 2026-08-30).
Multidisciplinary development included consumer representatives.
Its national implementation context and intervention access differ from US and UK documents.

EULAR hip/knee non-pharmacological core management (2023 update)¶

Two overarching principles and eight recommendations covering an individualised multicomponent plan; information/education/self-management; exercise dose and delivery; healthy weight; and related core non-drug care (Moseng 2024, PMID 38212040).
Explicit successor to Fernandes 2013 (PMID 23595142), whose 11 recommendations had panel agreement 8.0–9.1/10.
Does not replace OARSI/ACR/NICE pharmacologic recommendations.

ESCEO 2019 knee algorithm¶

GRADE-informed stepwise algorithm with 15 voted recommendations, mixing strong and weak ratings (Bruyère 2019, PMID 31126594).
More permissive of background SYSADOA/paracetamol than NICE NG226, which does not routinely offer paracetamol and does not offer glucosamine.
Algorithm, not a national CPG.

French nonpharmacologic knee OA (2024)¶

Joint recommendations of rheumatology and physical/rehabilitation societies (Pers 2024, PMID 39490291).
Useful as a contemporary focused complement to broad pharmacologic guidelines.
Its narrower scope should not be misread as silence on drug or surgical care.

Supersession chains¶

Topic	Chain
UK comprehensive OA	NICE CG177 (2014) → NICE NG226 (2022)
ACR hand/hip/knee	ACR 2012 (PMID 22563589) → ACR/AF 2019 (PMID 31908149)
OARSI knee/nonsurgical	OARSI 2008/2010 series → OARSI 2014 (PMID 24462672) → OARSI 2019 (PMID 31278997)
AAOS knee nonarthroplasty	AAOS 2013 second edition (PMID 23996988) → AAOS 2021 third edition (PMID 35383651)
EULAR hand management	EULAR 2007 (PMID 17046965) → EULAR 2018 update (PMID 30154087)
EULAR hip/knee nonpharm	Fernandes 2013 (PMID 23595142) → Moseng 2023/2024 update (PMID 38212040)
RACGP hip/knee	RACGP 2009 → RACGP second edition 2018

Disagreements and gaps¶

Issue	More favorable / permissive	More restrictive	Why the conflict persists
Intra-articular hyaluronan	Some expert algorithms and practice pathways allow selected use	NICE says do not offer; ACR/AF recommends against routine knee use	Small-study effects, product heterogeneity, contextual effects, cost and different minimum-important-benefit thresholds
PRP	Orthobiologic consensus statements allow selected knee-OA use	ACR/AF recommends against; NICE 2022 does not recommend routine use	Product standardization, placebo-controlled evidence and evidence cut-off differ
Acupuncture	ACR/AF conditional recommendation	NICE says do not offer	Small effects, sham choice, cost-effectiveness and panel weighting
Acetaminophen	ACR/AF conditional option	NICE: not routine, only infrequent short-term when alternatives unsuitable	Small average benefit and differing concern about NSAID contraindications
Knee bracing	ACR/AF strongly recommends tibiofemoral bracing in the matching phenotype	NICE discourages routine devices unless instability/abnormal load and exercise inadequate	Phenotype selection, adherence and service-cost assumptions
Arthroplasty eligibility	NICE rejects exclusion solely by BMI/age/smoking	Local institutional thresholds often persist	Surgical risk prediction, resource allocation and equity are not resolved by efficacy trials
Imaging	NICE favors clinical diagnosis without routine imaging	Surgical and research pathways use radiographs for anatomy and staging	Diagnostic confirmation, differential diagnosis, trial classification and operative planning are different use cases

Watch list¶

Recheck NICE NG226 when its surveillance page reports a review decision.
Recheck OARSI for a successor to the 2019 nonsurgical guideline.
Check whether AAOS posts a fourth knee nonarthroplasty edition or revises PRP/hyaluronate language.
Seek current official replacements for Italian 2013, Turkish 2020, Dutch 2020 and Mexican 2008 documents.
Track new EULAR hand OA and imaging updates.
Recheck EULAR 2023 nonpharm document for a pharmacologic companion.
Track guidance incorporating semaglutide/large pharmacologic weight loss for obesity-associated knee OA. NICE NG226 already states 10% loss is likely better than 5%; it does not yet name GLP-1 agonists.
Track formal product-standard requirements for PRP and cell-based injections.

Verification caveats¶

PubMed verifies the indexed publication, not the issuing body's current-status designation.
Official sites can update without a new PMID; all URL statuses are point-in-time observations on 2026-08-30.
Several national documents are language- or archive-limited; these are labeled uncertain rather than silently treated as current.