EUROVISCO Recommendations for Optimizing the Clinical Results of Viscosupplementation in Osteoarthritis

[en] Objectives: The 3 aims of the work were to identify population subgroups that can benefit the most from viscosupplementation (VS), to provide recommendations on injection techniques, and to discuss VS appropriateness in clinical situations that are commonplace in daily practice. Methods: The task force members voted on their degree of agreement on 27 statements, 36 recommendations, and 22 clinical scenarios using a 9-point scale. The strength of agreement/appropriateness/recommendation (SOA/SOR) was classified as strong if the median agreement score was ≥8. The level of consensus (LOC) was also obtained. Results: Among the assumed predictors for VS failure, obesity, radiographic severity, large synovial fluid effusion, severe patellofemoral involvement, major malalignment, and gross joint instability received a large majority of agreements. The lateral mid-patellar approach was recommended for knee injection. Imaging guidance was unanimously recommended for hip and ankle. Agreement was achieved to strictly respect the dosing regimen proven by controlled trials. There was agreement for treating with VS patients with mild to moderate knee and hip OA, with normal weight or moderate overweight, insufficiently improved by first-line therapies, or who do not wish get oral treatment or who have contraindications to pain killers. The group considered the patient’s wishes as a key element in therapeutic decision making. Conclusion: Based on literature data and clinical experience, the EUROVISCO group proposed a set of recommendations for optimizing the results of VS, aimed to help practitioners, especially in some cases in which the patients’ specificities make the therapeutic decision difficult. © 2018, The Author(s) 2018.

Disciplines :

Rheumatology

Author, co-author :

Conrozier, T.; Department of Rheumatology, Hôpital Nord Franche-Comté, Belfort, France

Monfort, J.; Servei de Reumatologia, Hospital del Mar, Barcelona, Spain

Chevalier, X.; Paris XII University, UPEC, Department of Rheumatology, Henri Mondor Hospital, Creteil, France

Raman, R.; Academic Department of Orthopaedics, Hull and East Yorkshire NHS Trust Castle Hill Hospital, Cottingham, UK

Richette, P.; Université Paris Diderot, UFR Médicale, Hôpital Lariboisière, Paris, France

Diraçoglù, D.; Department of Physical Medicine and Rehabilitation, Istanbul University and Istanbul Faculty of Medicine, Istanbul, Turkey

Bard, H.; Department of Orthopaedics-Rheumatology, American Hospital of Paris, Neuilly/Seine, France

Baron, D.; Centre de réadaptation fonctionnelle de Lannion-Trestel, Trévou-Tréguignec, France

Jerosch, J.; Orthopedic Department, Johanna-Etienne-Hospital, Neuss, Nordrhein-Westfalen, Germany

Migliore, A.; U.O.S. of Rheumatology, Ospedale San Pietro Fatebenefratelli, Rome, Italy

Henrotin, Yves ; Université de Liège - ULiège > Département des sciences de la motricité > Unité de recherche sur l'os et le cartilage (U.R.O.C.)

Language :

English

Title :

EUROVISCO Recommendations for Optimizing the Clinical Results of Viscosupplementation in Osteoarthritis

Publication date :

2018

Journal title :

Cartilage

ISSN :

1947-6035

eISSN :

1947-6043

Publisher :

SAGE Publications Inc.

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 22 April 2020

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