[en] [en] OBJECTIVES: Viscosupplementation with hyaluronic acid (HA) is a commonly used intra-articular treatment for osteoarthritis (OA). We performed a Delphi consensus process to formulate guidelines for the use of intra-articular hyaluronic acid (IAHA) knee injection according to the patient's characteristics.
METHODS: The EUROVISCO group consists of 12 members who had expertise in clinical and/or research in the field of OA and IAHA treatment. This group drafted issues through an iterative process and subsequently voted according to a Delphi process on their level of agreement (LoA) on these recommendations. The scores were pooled to generate a median agreement score for each recommendation. The strength of the recommendation (SOR) was classified as strong if the median agreement score was ≥8. The level of consensus (LOC) was also obtained. The level of evidence was given for each recommendation.
RESULTS: A total of 34 statements were evaluated by the expert group. A unanimous or high LoA was obtained in 16. IAHA can be considered irrespective of the age in patients with symptomatic knee OA. It can be used in patients with diabetes and/or moderate to severe obesity. It can also be used in knee OA patients with a history of gout, meniscocalcinosis and with mild-to-moderate varus/valgus malalignment. The group recommended against the use of VS in pregnant women and in OA flare.
CONCLUSION: In summary, the working group provided strong recommendations for the use of IAHA injection that will facilitate individualized treatment decision algorithms in the management of knee OA.
Disciplines :
Rheumatology
Author, co-author :
Conrozier, Thierry ; Department of Rheumatology, Hôpital Nord Franche-Comté, Belfort, France
Raman, Raghu; Academic Unit of Orthopaedics and Rheumatology, Department of Orthopaedics, Chennai Meenakshi Multispeciality Hospital, Chennai, India
Diraçoglu, Demirhan; Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
Montfort, Jordi; Servei de Reumatologia, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
Bard, Hervé; Rheumatology Cabinet Medical Vaudoyer, Paris, France
Baron, Dominique; Centre de réadaptation fonctionnelle de Lannion-Trestel, Trévou-Tréguignec, France
Goncalves, Belarmino; Serviço de Radiologia de Intervenção, Instituto Português de Oncologia-FG, Porto, Portugal
Richette, Pascal; UFR médicale, Hôpital Lariboisière, Université Paris Diderot, Paris, France
Migliore, Alberto; U.O.S. of Rheumatology, Ospedale San Pietro Fatebenefratelli, Rome, Italy
Chevalier, Xavier; Paris XII University, UPEC, Department of Rheumatology, Henri Mondor Hospital, Creteil, France
Brittberg, Mats; Cartilage Research Unit, Institution of Clinical Sciences, Department of Orthopedics, University of Gothenburg and Team Orthopedic Research, Cartibase, Varberg, Sweden
Henrotin, Yves ; Université de Liège - ULiège > Département des Sciences de l'activité physique et de la réadaptation > Pathologie générale et physiopathologie - Techniques particulières de kinésithérapie ; Physical Therapy and Rehabilitation Department, Princess Paola Hospital, Vivalia, Marche-en-Famenne, Belgium
Language :
English
Title :
EUROVISCO Consensus Guidelines for the Use of Hyaluronic Acid Viscosupplementation in Knee Osteoarthritis Based on Patient Characteristics.
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