PainRelief.com Interview with:
Dylan Wolff
M.D. Candidate

Mary K. Mulcahey, MD, FAAOS, FAOA
Director, Women’s Sports Medicine Program
Associate Professor
Assistant Program Director
Department of Orthopaedic Surgery
Tulane University School of Medicine
New Orleans, LA

PainRelief.com:  What is the background for this study?  What are the main findings?

Response: Osteoarthritis Research Society (OARSI) guidelines include topical non-steroidal anti-inflammatory drugs (NSAIDs) as a level 1A recommendation for non-operative management of knee osteoarthritis, but previous reviews have demonstrated that clinical adoption of this treatment option lags. We conducted a systematic review and meta-analysis of 18 studies evaluating diclofenac, ketoprofen, and ibuprofen in topical preparations. We found that they are safe and effective for reducing pain and improving physical function in patients with knee osteoarthritis. Diclofenac had the strongest quality and number of studies and showed a moderate effect size for symptomatic improvement. With regards to safety, adverse events were low in the topical treatment groups, and topical preparations containing dimethyl sulfoxide (DMSO) showed a higher odds ratio for adverse events than preparations without DMSO.