2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee

Arthritis Care and Research - Tập 72 Số 2 - Trang 149-162 - 2020
Sharon L. Kolasinski1, Tuhina Neogi2, Marc C. Hochberg3, Carol A. Oatis4, Gordon Guyatt5, Joel A. Block6, Leigh F. Callahan7, Cindy Copenhaver8, Carole Dodge9, David T. Felson2, Kathleen Gellar10, William F. Harvey11, Gillian Hawker12, Edward Herzig13, C. Kent Kwoh14, Amanda E. Nelson7, Jonathan Samuels15, Carla R. Scanzello1, Daniel K. White16, Burton L. Wise17, Roy D. Altman18, Dana DiRenzo19, Joann Fontanarosa20, Gina Giradi20, Mariko Ishimori21, Devyani Misra2, Amit Shah22, Anna Shmagel23, Louise M. Thoma7, Marat Turgunbaev22, Amy S. Turner22, James Reston20
1University of Pennsylvania School of Medicine, Philadelphia
2Boston University School of Medicine, Boston, Massachusetts
3University of Maryland School of Medicine and Veterans Affairs Maryland Health Care System, Baltimore
4Arcadia University, Glenside, Pennsylvania
5McMaster University, Hamilton, Ontario, Canada
6Rush University Medical Center, Chicago, Illinois
7University of North Carolina School of Medicine, Chapel Hill
8South Holland Recreational Services, University of Chicago, and Ingalls Memorial Hospital, Thornton, Illinois
9University of Michigan Medical Center, Ann Arbor
10Watchung, New Jersey
11Tufts Medical Center, Boston, Massachusetts
12University of Toronto, Toronto, Ontario, Canada
13Fairfield, Ohio
14University of Arizona, College of Medicine, Tucson
15New York University Langone Medical Center, New York, New York
16University of Delaware, Newark
17University of California, Davis
18Ronald Reagan–UCLA Medical Center, Los Angeles, California
19Johns Hopkins University School of Medicine, Baltimore, Maryland
20ECRI Institute, Plymouth Meeting, Pennsylvania
21Cedars Sinai Medical Center, Los Angeles, California
22American College of Rheumatology Atlanta Georgia
23University of Minnesota, Minneapolis

Tóm tắt

ObjectiveTo develop an evidence‐based guideline for the comprehensive management of osteoarthritis (OA) as a collaboration between the American College of Rheumatology (ACR) and the Arthritis Foundation, updating the 2012 ACR recommendations for the management of hand, hip, and knee OA.MethodsWe identified clinically relevant population, intervention, comparator, outcomes questions and critical outcomes in OA. A Literature Review Team performed a systematic literature review to summarize evidence supporting the benefits and harms of available educational, behavioral, psychosocial, physical, mind‐body, and pharmacologic therapies for OA. Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of the evidence. A Voting Panel, including rheumatologists, an internist, physical and occupational therapists, and patients, achieved consensus on the recommendations.ResultsBased on the available evidence, either strong or conditional recommendations were made for or against the approaches evaluated. Strong recommendations were made for exercise, weight loss in patients with knee and/or hip OA who are overweight or obese, self‐efficacy and self‐management programs, tai chi, cane use, hand orthoses for first carpometacarpal (CMC) joint OA, tibiofemoral bracing for tibiofemoral knee OA, topical nonsteroidal antiinflammatory drugs (NSAIDs) for knee OA, oral NSAIDs, and intraarticular glucocorticoid injections for knee OA. Conditional recommendations were made for balance exercises, yoga, cognitive behavioral therapy, kinesiotaping for first CMC OA, orthoses for hand joints other than the first CMC joint, patellofemoral bracing for patellofemoral knee OA, acupuncture, thermal modalities, radiofrequency ablation for knee OA, topical NSAIDs, intraarticular steroid injections and chondroitin sulfate for hand OA, topical capsaicin for knee OA, acetaminophen, duloxetine, and tramadol.ConclusionThis guideline provides direction for clinicians and patients making treatment decisions for the management of OA. Clinicians and patients should engage in shared decision‐making that accounts for patients’ values, preferences, and comorbidities. These recommendations should not be used to limit or deny access to therapies.

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Arthritis Care and Research

Tập 72 Số 2

149-162

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