Which statement about osteoarthritis of the knee management is true?

• A. NSAIDs
• B. Corticosteroids should be used as first-line therapy
• C. Total knee replacement is preferred initially
• D. Bed rest is recommended

Answer: (A)

Pain control in knee osteoarthritis is best achieved with NSAIDs as the first-line pharmacologic option after incorporating nonpharmacologic strategies. NSAIDs reduce pain and inflammation by inhibiting prostaglandin synthesis, helping many patients regain function and participate in activity. While acetaminophen can be used when NSAIDs are contraindicated, NSAIDs generally provide more effective relief for knee OA.

Corticosteroids are not first-line due to potential systemic side effects and longer-term risks; they are typically reserved for short courses or intra-articular injections when symptoms flare or NSAIDs are insufficient. Total knee replacement is a surgical option reserved for severe, disabling disease after failure of conservative measures. Bed rest is not recommended, as prolonged immobility worsens stiffness and functional decline; maintaining activity with low-impact exercise and physical therapy is encouraged.