Pain Medication Acetaminophen (Tylenol) is a non-narcotic analgesic that can be effective in treating mild to moderate symptoms of OA. Acetaminophen does not have any anti-inflammatory activity and is purely an analgesic. As such, it avoids many of the complications that are associated with oral anti-inflammatory medications. Nonsteroidal anti-inflammatory drugs (NSAIDs) can be very effective in treating the symptoms of OA as they are focused on treating inflammation. They may work very well in some patients while they may not work at all in others. The significant problem with these medications is that they are oral systemic medications which can lead to complications such as hypertension, GI bleeding, kidney and cardiac problems. These risks increase with age. Since symptomatic OA typically occurs in a single or small number of joints, it is preferable to treat most patients with local therapies rather than with a systemic drug that has a significant risk for body-wide toxicity. ​ While narcotic analgesics may serve a limited role in the short term management of severe osteoarthritic pain associated with an acute inflammatory flare up, they should be strongly avoided for use in the management of chronic osteoarthritic pain.

Osteotomy Osteotomy is a less common surgical procedure used in knee OA. The procedure involves removing a small section of bone to relieve pain and pressure that results from the osteoarthritic condition, typically due to cartilage degeneration. The surgery can be given in lieu of a knee replacement when the issue is more localized, or it can sometimes be performed along with a knee replacement surgery.

Arthroscopy The least invasive surgical procedure that may be effective for OA is arthroscopy. Its greatest strength is in treating mechanical symptoms such as unstable flaps of articular cartilage, loose fragments, or very unstable meniscus tears. It also has the potential to treat inflammatory symptoms, as the pro-inflammatory molecules released from failing cartilage are washed out of the joint at the time of arthroscopy. However, the surgical trauma created by the procedure itself creates an acute post-surgical inflammation. Thus, it is very important to aggressively treat post-surgical inflammation in order to maximize the potential benefits from arthroscopy. The use of arthroscopy in the management of OA, particularly knee OA, has been controversial. There are studies both supporting and questioning the effectiveness of this treatment option.