Modern approaches to the conservative treatment of osteoarthritis from the standpoint of evidence-based medicine

Authors

DOI:

https://doi.org/10.15674/0030-59872020399-105

Keywords:

osteoarthritis, treatment clinical recommendations evidence, based medicine, intra-articular injections, SYSADOA

Abstract

Evidence-based medicine plays a leading role in modern clinical practice. The most well-known scales for evaluating the quality of evidence and recommendations based on them are OCEBM (Oxford Centre for Evidence-based Medicine), GRADE (Grading of Recommendations Assessment, Development and Evaluation), NICE (National Institute for Health and Care excellence). Objective: to acquaint readers with modern clinical guidelines for conservative treatment of osteoarthritis (OA), developed on the basis of the principles of evidence-based medicine. GRADE scale is widely used. The greatest authority among professionals have community leaders: ACR (American College of Rheumatologists), EULAR (European Antirheumatic League), OARSI (International Society of Osteoarthritis Researchers), AAOS (American Academy of Orthopedic Surgeons), ESCEO (European Society for Clinical and Economic Studies aspects of osteoporosis, osteoarthritis and musculoskeletal diseases). Their differences are due, in particular, to the use of different scales for assessing the levels of evidence and strength recommendations and relating to the use of SYSADOA (symptomatic slow-acting drugs for the treatment of OA), intra-articular injections of various drugs (corticosteroids, PRP, hyaluronic acid, etc.). The article presents strictly and conditionally recommended methods of conservative treatment of osteoarthritis of the hand, knee and hip joints. Conclusions: modern clinical guidelines are based on objective scales for evaluating evidence and recommendations, respectively, the probability of systematic errors is reduced. Therefore, prescribing according to them OA treatment regimes, we are sure that we choose the most effective among all available approaches.

Author Biography

Volodymyr Filipenko, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD, Prof. in Traumatology and Orthopaedics

References

  1. Sackett, D. L., Rosenberg, W. M., Gray, J. A., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: What it is and what it isn't. BMJ, 312(7023), 71-72. doi:10.1136/bmj.312.7023.71
  2. The Oxford 2011 Levels of Evidence. Levels of Evidence Working Group Oxford Centre for Evidence-Based Medicine. Retrieved from: https://www.cebm.net/ wp-content/uploads/2014/06/CEBM-Levels-of-Evidence- 2.1.pdf; http://www.cebm.net/index.aspx?o=5653.
  3. Guyatt, G. H., Oxman, A. D., Kunz, R., Falck-Ytter, Y., Vist, G. E., Liberati, A., & Schünemann, H. J. (2008). Going from evidence to recommendations. BMJ, 336(7652), 1049-1051. doi:10.1136/bmj.39493.646875.ae
  4. What is osteoarthritis? OARSI. Retrieved from: https://www.oarsi.org/what-osteoarthritis
  5. Berenbaum, F. (2013). Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!). Osteoarthritis and Cartilage, 21(1), 16-21. doi:10.1016/j.joca.2012.11.012
  6. Kolasinski, S. L., Neogi, T., Hochberg, M. C., Oatis, C., Guyatt, G., Block, J., … & Reston, J. (2020). 2019 American College of rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Care & Research, 72(2), 149-162. doi:10.1002/acr.24131
  7. Bannuru, R., Osani, M., Vaysbrot, E., Arden, N., Bennell, K., Bierma-Zeinstra, S., … & McAlindon, T. (2019). OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis and Cartilage, 27(11), 1578-1589. doi:10.1016/j.joca.2019.06.011
  8. Kloppenburg, M., Kroon, F. P., Blanco, F. J., Doherty, M., Dziedzic, K. S., Greibrokk, E., … & Carmona, L. (2018). 2018 update of the EULAR recommendations for the management of hand osteoarthritis. Annals of the Rheumatic Diseases, 78(1), 16-24. doi:10.1136/annrheumdis-2018-213826
  9. Carlson, V. R., Ong, A. C., Orozco, F. R., Hernandez, V. H., Lutz, R. W., & Post, Z. D. (2018). Compliance with the AAOS guidelines for treatment of osteoarthritis of the knee. Journal of the American Academy of Orthopaedic Surgeons, 26(3), 103-107. doi:10.5435/jaaos-d-17-00164
  10. Management of osteoarthritis of the hip. Evidence-based clinical practice guideline. American Academy of Orthopaedic Surgeons (2017). Retrieved from: http:// www.orthoguidelines.org/topic?id=1021
  11. Bruyère, O., Honvo, G., Veronese, N., Arden, N. K., Branco, J., Curtis, E. M., … & Reginster, J. (2019). An updated algorithm recommendation for the management of knee osteoarthritis from the European society for clinical and economic aspects of osteoporosis, osteoarthritis and musculoskeletal diseases (ESCEO). Seminars in Arthritis and Rheumatism, 49(3), 337-350. doi:10.1016/j.semarthrit.2019.04.008
  12. Zhang, W. (2005). EULAR evidence based recommendations for the management of hip osteoarthritis: Report of a task force of the EULAR standing committee for international clinical studies including therapeutics (ESCISIT). Annals of the Rheumatic Diseases, 64(5), 669-681. doi:10.1136/ard.2004.028886
  13. Jordan, K. M. (2003). EULAR recommendations 2003: An evidence based approach to the management of knee osteoarthritis: Report of a task force of the standing committee for international clinical studies including therapeutic trials (ESCISIT). Annals of the Rheumatic Diseases, 62(12), 1145-1155. doi:10.1136/ard.2003.011742
  14. Vannabouathong, C., Bhandari, M., Bedi, A., Khanna, V., Yung, P., Shetty, V., & Khan, M. (2018). Nonoperative treatments for knee osteoarthritis. JBJS Reviews, 6(7), e5. doi:10.2106/jbjs.rvw.17.00167
  15. Zhang, W. (2006). EULAR recommendations for knee and hip osteoarthritis: A critique of the methodology. British Journal of Sports Medicine, 40(8), 664-669. doi:10.1136/bjsm.2004.016840
  16. Ter-Vartanyan, S. Kh., Golovach, I. Yu., & Egudina, E. D. (2019). Management of patients with osteoarthritis of the knee joints: analysis and discussion of the main provisions and recommendations of ESCEO 2019. Health of Ukraine. Cardiology. Rheumatology. Cardiac surgery, 3(64), 9–11, 50–51. [in Russian]

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How to Cite

Filipenko, V. (2023). Modern approaches to the conservative treatment of osteoarthritis from the standpoint of evidence-based medicine. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (3), 99–105. https://doi.org/10.15674/0030-59872020399-105

Issue

No. 3 (2020)

Section

IN AID OF PRACTING DOCTOR. LECTURES

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