Recommendations from the French Societies of Rheumatology and Physical Medicine and Rehabilitation on the non-pharmacological management of knee osteoarthritis.
[en] [en] BACKGROUND: Although non-pharmacological therapies for knee osteoarthritis (OA) are essential pillars of care, they are often poorly considered and inconsistently applied.
OBJECTIVES: Under the umbrella of the French Society of Rheumatology (SFR) and the French Society of Physical Medicine and Rehabilitation (SOFMER), we aimed to establish consensual recommendations for the non-pharmacological management of people with knee OA.
METHODS: A group of fellows performed a systematic literature review on the efficacy and safety of non-pharmacological modalities (up to October 2021). The fellows then took part in discussions with a multidisciplinary group of experts to draft a list of recommendations. The list was then submitted to an independent reading committee who rated their level of agreement with each recommendation. Each recommendation was assigned a strength of recommendation and a level of evidence.
RESULTS: Five general principles were unanimously accepted: (A) the need to combine non-pharmacological and pharmacological measures; (B) the need for personalized management; (C) the need to promote adherence; (D) the need for adapted physical activity; and (E) the need for person-centered education. Specific positive or negative recommendations were defined for 11 modalities: (1) unloading knee brace; (2) kinesiotaping or knee sleeves; (3) shoes and/or insoles; (4) using a cane; (5) physical exercise program; (6) joint mobilization; (7) electro- or thermo-therapy; (8) acupuncture; (9) weight loss; (10) thermal spa therapy; and (11) workplace accommodation.
CONCLUSIONS: These SFR/SOFMER recommendations provide important and consensual knowledge to assist health professionals in decision-making for non-pharmacological treatments for knee OA.
Disciplines :
Rheumatology
Author, co-author :
Pers, Yves-Marie ; IRMB, University of Montpellier, INSERM, Clinical immunology and osteoarticular diseases Therapeutic Unit, Lapeyronie University Hospital, CHU Montpellier, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier CEDEX 05, France. Electronic address: ym-pers@chu-montpellier.fr
Nguyen, Christelle ; Université Paris Cité, Faculté de Santé, UFR de Médecine, 15, rue de l'école de médecine, 75006 Paris, France, AP-HP.Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, 27 rue du Faubourg Saint-Jacques, Paris 75014, France, INSERM UMR-S 1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs (T3S), Campus Saint-Germain-des-Prés, 45 rue des Saints-Pères, 75006 Paris, France. Electronic address: christelle.nguyen2@aphp.fr
Borie, Constance ; Université Clermont Auvergne, Service de Santé Universitaire, 25 rue Etienne Dolet, 63000, Clermont-Ferrand, France
Daste, Camille; Université Paris Cité, Faculté de Santé, UFR de Médecine, 15, rue de l'école de médecine, 75006 Paris, France, AP-HP.Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, 27 rue du Faubourg Saint-Jacques, Paris 75014, France, INSERM UMR-S 1153, Centre de Recherche Épidémiologie et Statistique, ECaMO Team, 27 rue du Faubourg Saint-Jacques, Paris 75014, France. Electronic address: camille.daste@aphp.fr
Kirren, Quentin; Université Paris Cité, Faculté de Santé, UFR de Médecine, 15, rue de l'école de médecine, 75006 Paris, France, AP-HP.Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, 27 rue du Faubourg Saint-Jacques, Paris 75014, France. Electronic address: kirren.quentin@hotmail.fr
Lopez, Cyril; Desbrest Institute of Epidemiology and Public Health, UMR 1318 INSERM, University of Montpellier - INRIA, 641 avenue Giraud, 34093 Montpellier, France
Ouvrard, Gaëlle; Service de Neuro-orthopédie, Assistance Publique Hôpitaux de Paris, Sorbonne Université, Rothschild Hospital, 5 rue Santerre, Paris 75012, France. Electronic address: gaelle.ouvrard@aphp.fr
Ruscher, Romane; IRMB, University of Montpellier, INSERM, Clinical immunology and osteoarticular diseases Therapeutic Unit, Lapeyronie University Hospital, CHU Montpellier, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier CEDEX 05, France. Electronic address: ruscher.romane@orange.fr
Argenson, Jean-Noël; Aix-Marseille University, AP-HM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopedics and Traumatology, 249 Bd de Sainte-Marguerite, 13009 Marseille, France. Electronic address: Jean-noel.ARGENSON@ap-hm.fr
Bardoux, Sylvie; Service de Médecine Physique et de Réadaptation, CHU Clermont-Ferrand, Université Clermont Auvergne, INRAE, UNH, 58 rue Montalembert, 63000 Clermont-Ferrand, France
Baumann, Laurence; Université Paris Cité, Faculté de Santé, UFR de Médecine, 15, rue de l'école de médecine, 75006 Paris, France. Electronic address: bestdoctorintown@orange.fr
Berenbaum, Francis; Department of Rheumatology, Saint-Antoine Hospital, Assistance Publique-Hopitaux de Paris, Sorbonne Université, Inserm UMRS_938, FHU PaCeMM Paris, 184 rue du Faubourg Saint-Antoine, 75012 Paris, France. Electronic address: francis.berenbaum@aphp.fr
Binard, Aymeric; Department of Rheumatology, CHU de la Cavale-Blanche, 29609 Bd Tanguy Prigent, 29100 Brest, France
Coudeyre, Emmanuel ; Service de Médecine Physique et de Réadaptation, CHU Clermont-Ferrand, Université Clermont Auvergne, INRAE, UNH, 58 rue Montalembert, 63000 Clermont-Ferrand, France. Electronic address: ecoudeyre@chu-clermontferrand.fr
Czernichow, Sébastien ; Université Paris Cité, INSERM, UMR1153, Methods Team, Epidemiology and Biostatistics Sorbonne Paris Cité Center, 27 rue du Faubourg Saint-Jacques, Paris 75014, France, Service de nutrition, centre spécialisé Obésité, APHP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France. Electronic address: sebastien.czernichow@aphp.fr
Dupeyron, Arnaud ; Université Montpellier, Faculté de Médecine, 641 Avenue du Doyen Gaston Giraud, 34295 Montpellier, France, Service de Médecine Physique et de Réadaptation, CHU Nîmes, Univ Montpellier, 4 rue du Professeur Robert Debré, 30029 Nîmes, France, EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, 700 Avenue du Pic Saint-Loup, 34090 Montpellier, France. Electronic address: arnaud.dupeyron@umontpellier.fr
Fabre, Marie-Christine; AFLAR, Association Française de Lutte Anti-Rhumatismale, 2 rue Bourgon, 75013 Paris, France. Electronic address: mariec.fabre@orange.fr
Foulquier, Nathan; LBAI, UMR1227, Univ Brest, Inserm, 9 rue Felix Le Dantec, 29200 Brest, France, DDS, CHU de Brest, 2 Avenue Foch, 29200 Brest, France
GERARD, Caroline ; Centre Hospitalier Universitaire de Liège - CHU > > Service de rhumatologie ; AP-HP.Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, 27 rue du Faubourg Saint-Jacques, Paris 75014, France. Electronic address: caroline.gerard@aphp.fr
Hausberg, Vivien; Kinésithérapeute Ostéopathe liberal, 107 rue Andy Wharol, 34000 Montpellier, France
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
Jeandel, Claude; Directeur de l'Ecole de Gériatrie et Gérontologie, Université de Montpellier, 641 Avenue du Doyen Gaston Giraud, 34295 Montpellier, France. Electronic address: claudejeandel@yahoo.fr
Lesage, François-Xavier; Desbrest Institute of Epidemiology and Public Health, UMR 1318 INSERM, University of Montpellier - INRIA, 641 avenue Giraud, 34093 Montpellier, France. Electronic address: fx-lesage@chu-montpellier.fr
Liesse, Brigitte; AFLAR, Association Française de Lutte Anti-Rhumatismale, 2 rue Bourgon, 75013 Paris, France. Electronic address: b.liesse@orange.fr
Mainard, Didier; Université de Lorraine, CNRS, IMoPA, 9 Av de la Forêt de Haye, 54500 Vandœuvre-lès-Nancy, France, Service de Chirurgie Orthopédique, Traumatologique et Arthroscopique, CHRU Nancy, 29 Av du maréchal de Lattre de Tassigny, CO 60034, 54035 Nancy, France. Electronic address: didier.mainard@univ-lorraine.fr
Michel, Fabrice ; Université de Liège - ULiège > Département de physique > Physique générale (caractérisation optique et magnétique des matériaux) ; Service de Médecine Physique et de Réadaptation, CHU Jean Minjoz, 3 Bd Alexandre Fleming, 25000 Besançon, France, Laboratoire de Nanomédecine, Imagerie, Thérapeutique, Université de Franche Comté, 16 route de Gray, 25030 Besançon, France
Ninot, Grégory; Desbrest Institute of Epidemiology and Public Health, UMR 1318 INSERM, University of Montpellier - INRIA, 641 avenue Giraud, 34093 Montpellier, France. Electronic address: gregory.ninot@umontpellier.fr
Ornetti, Paul ; INSERM, CIC 1432, Module Plurithématique, Plateforme d'Investigation Technologique, 2 Bd Maréchal de Lattre de Tassigny, 21000 Dijon, France, INSERM, UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, 3 allée des Stades Universitaires, 21078 Dijon, France, Rheumatology Department, CHU Dijon-Bourgogne, 2 Bd Maréchal de Lattre de Tassigny, 21000 Dijon, France. Electronic address: paul.ornetti@chu-dijon.fr
Oude-Engberink, Agnès; Desbrest Institute of Epidemiology and Public Health, UMR 1318 INSERM, University of Montpellier - INRIA, 641 avenue Giraud, 34093 Montpellier, France. Electronic address: agnes.oude-engberink@umontpellier.fr
Rat, Anne-Christine; Caen Normandie University, INSERM, U1075 COMETE, 2 rue des Rochambelles, 14032 Caen, France, Rheumatology Department, University Hospital Center Caen, Av de la Côte de Nacre, 14000 Caen, France. Electronic address: rat-ac@chu-caen.fr
Richette, Pascal; Department of Rheumatology, Lariboisière Hospital, AP-HP, Université de Paris, INSERM U1132, 2 rue Ambroise Paré, 75010 Paris, France. Electronic address: pascal.richette@aphp.fr
Roren, Alexandra ; Université Paris Cité, Faculté de Santé, UFR de Médecine, 15, rue de l'école de médecine, 75006 Paris, France, AP-HP.Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, 27 rue du Faubourg Saint-Jacques, Paris 75014, France, INSERM UMR-S 1153, Centre de Recherche Épidémiologie et Statistique, ECaMO Team, 27 rue du Faubourg Saint-Jacques, Paris 75014, France. Electronic address: alexandra.roren@u-paris.fr
Thoumie, Philippe; Service de Médecine Physique et Réadaptation, Assistance Publique Hôpitaux de Paris, Rothschild Hospital and Sorbonne University Agathe INSERM U1150, 5 rue Santerre, 75012 Paris, France. Electronic address: philippe.thoumie@aphp.fr
Walrand, Stéphane; Université Clermont Auvergne, CHU Clermont-Ferrand, INRAE, UNH, 49 Bd François Mitterrand, Clermont-Ferrand 63001, France. Electronic address: stephane.walrand@inrae.fr
Rannou, François ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé ; Université Paris Cité, Faculté de Santé, UFR de Médecine, 15, rue de l'école de médecine, 75006 Paris, France, AP-HP.Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, 27 rue du Faubourg Saint-Jacques, Paris 75014, France, INSERM UMR-S 1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs (T3S), Campus Saint-Germain-des-Prés, 45 rue des Saints-Pères, 75006 Paris, France. Electronic address: francois.rannou@aphp.fr
Sellam, Jérémie; Department of Rheumatology, Saint-Antoine Hospital, Assistance Publique-Hopitaux de Paris, Sorbonne Université, Inserm UMRS_938, FHU PaCeMM Paris, 184 rue du Faubourg Saint-Antoine, 75012 Paris, France. Electronic address: jeremie.sellam@aphp.fr
Société Française de Rhumatologie and Société Française de Médecine Physique et de Réadaptation
Recommendations from the French Societies of Rheumatology and Physical Medicine and Rehabilitation on the non-pharmacological management of knee osteoarthritis.
Sylvie Egger (French Society for Rheumatology) for taking care of the logistics of the recommendations; Marie-Christine Fabre, Brigitte Liesse, and Fran\u00E7oise Alliot-Launois (AFLAR).
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