EUROVISCO; hyaluronic acid; knee osteoarthritis; recommendations; viscosupplementation; Medicine (all); Physical Therapy, Sports Therapy and Rehabilitation; Biomedical Engineering; Immunology and Allergy
Abstract :
[en] ("[en] RATIONALE: Viscosupplementation (VS) with hyaluronic acid is widely used in the management of knee osteoarthritis. There is no clear recommendation on the decision-making to achieve VS.
DESIGN: Based on extensive research of the literature and expert opinion, the members of the EUROVISCO (European Viscosupplementation Consensus Group) task force were asked to give their degree of agreement with 60 issues, using a Delphi method.
RESULTS: The expert panel achieved unanimous agreement in favor of the following statements: It is recommended to assess pain on a visual or 10-point numeric scale before considering VS. VS can be considered for patients with pain scores between 3 and 8. A standard x-ray must be obtained before the decision of VS. If the x-ray is normal, osteoarthritis must be confirmed by MRI or computed tomography (CT) arthrogram before considering VS. The aims of VS are relieving pain, improving function, and reducing non-steroidal anti-inflammatory drug (NSAID) consumption. The use of VS must not be considered for treating an osteoarthritis flare. VS can be envisaged as a first-line pharmacological treatment in patients having a contra-indication to NSAIDs or analgesics. VS can be considered in patients with contra-indications to arthroplasty. In the case of severe comorbidities (diabetes, hypertension, gastrointestinal disorders, renal failure), VS can avoid the use of potentially dangerous treatments. VS can be considered in patients receiving antiplatelet agents, vitamin K antagonists, and direct factor Xa or thrombin inhibitors. Five other statements obtained a high level of consensus.
CONCLUSION: These recommendations, illustrated in a decision algorithm, have been established to help practitioners in the decision-making of knee VS.","[en] ","")
Research Center/Unit :
CIRM - Centre Interdisciplinaire de Recherche sur le Médicament - ULiège
Disciplines :
Rheumatology
Author, co-author :
Conrozier, Thierry ; Department of Rheumatology, Hôpital Nord Franche-Comté, Belfort, France
Diraçoglù, Demirhan; Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
Monfort, Jordi; Servei de Reumatología, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
Chevalier, Xavier; Department of Rheumatology, Henri Mondor Hospital, Paris XII University, Creteil, France
Bard, Hervé; Rheumatology, Cabinet Médical Vaudoyer, Paris, France
Baron, Dominique; Centre de Réadaptation Fonctionnelle de Lannion-Trestel, Trévou-Tréguignec, France
Jerosch, Jörg; Department of Orthopedic, Johanna Etienne Hospital, Neuss, Germany
Migliore, Alberto; U.O.S. of Rheumatology, Ospedale San Pietro Fatebenefratelli, Rome, Italy
Richette, Pascal; Université Paris Cité, UFR Médicale, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Service de Rhumatologie, Paris, France
Henrotin, Yves ; Université de Liège - ULiège > Département des sciences de la motricité > Pathologie générale et physiopathologie - Techniques particulières de kinésithérapie
Language :
English
Title :
EUROVISCO Good Practice Recommendations for a First Viscosupplementation in Patients with Knee Osteoarthritis.
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