2017 update of the Turkish League Against Rheumatism (TLAR) evidence-based recommendations for the management of knee osteoarthritis
- 266 Downloads
In a Turkish League Against Rheumatism (TLAR) project, evidence-based recommendations for the management of knee osteoarthritis (OA) was developed for the first time in our country in 2012 (TLAR-2012). In accordance with developing medical knowledge and scientific evidence, recommendations were updated. The committee was composed of 22 physical medicine and rehabilitation specialists (4 have rheumatology subspeciality also) and an orthopaedic surgeon. Systematic literature search were applied on Pubmed, Embase, Cochrane and Turkish Medical Index for the dates between January the 1st 2012 and January the 29th of 2015. The articles were assessed for quality and classified according to hierarchy for the level of evidence, and the selected ones sent to committee members electronically. They were asked to develop new recommendations. In the meeting in 2015, the format of the recommendations was decided to be patient-based and considering the grade and the severity of the disease. By the discussion of the each item under the light of new evidences, the final recommendations were developed. Each item was voted electronically on a 10-cm visual analogue scale (VAS) and the strength of recommendation (SoR) was calculated. In the light of evidences, totally 11 titles of recommendations were developed; the first 7 were applicable to each patient in every stages of the disease, remaining were for defined specific clinical situations. The mean SoR value of the recommendations was between 7.44 and 9.93. TLAR-2012 recommendations were updated in a new format. We think that, present recommendations will be beneficial for the physicians who manage, as well as the patients who suffer from the disease.
KeywordsKnee osteoarthritis Treatment Evidence-based recommendations
We extend special thanks to Dr. Sevcan Uğur for her valuable scientific contribution during the reduction process of the manuscript.
Compliance with ethical standards
Conflict of interest
Dr. Tiraje Tuncer: no disclosure. Dr. H. Fatih Çay: honoraria from Abbvie, BMS, MSD, Pfizer, Roche and UCB Companies. Dr. Lale Altan: honoraria from Abbvie, Amgen, Lilly, MSD, Pfizer and Roche Companies Clinical Study support from: Abbvie and Lilly Companies. Dr. Gülcan Gürer: no disclosure. Dr. Cahit Kaçar: honoraria from Amgen, Biopharma and Sandoz Companies. Dr. Şüheda Özçakır: no disclosure. Dr.Şahap Atik: no disclosure. Dr. Figen Ayhan: no disclosure. Dr. Berrin Durmaz: no disclosure. Dr. Nurten Eskiyurt: no disclosure. Dr. Hakan Genç: no disclosure. Dr. Yeşim Gökçe Kutsal: no disclosure. Dr. Rezzan Günaydın: honoraria from Novartis, Pfizer and Sandoz Companies. Dr. Simin Hepgüler: no disclosure. Dr. Sami Hizmetli: honoraria from Abbvie, Roche and MSD Companies. Dr. Taciser Kaya: no disclosure. Dr. Yeşim Kurtaiş: no disclosure. Dr. Merih Sarıdoğan: no disclosure. Dr. Dilşad Sindel: honoraria from Amgen, Lilly and Sandoz Companies. Dr. Serap Sütbeyaz: no disclosure. Dr. Ömer Faruk Şendur: no disclosure. Dr. Hatice Uğurlu: no disclosure. Dr. Zeliha Ünlü: no disclosure.
This article does not contain any studies with human participants or animals performed by any of the authors.
- 4.Bruyère O, Cooper C, Pelletier JP, Branco J, Brandi ML, Guillemin F et al (2014) An algorithm recommendation for the management of knee osteoarthritis in Europe and internationally: a report from a task force of the European Society for clinical and economic aspects of osteoporosis and osteoarthritis (ESCEO). Semin Arthritis Rheum 44(3):253–63PubMedCrossRefGoogle Scholar
- 5.National Collaborating Centre for Chronic Conditions. NICE clinical guideline 59 (2008) Osteoarthritis: the care and management of osteoarthritis in adults. NICE 59:1–22. Available from: https://www.nice.org.uk/guidance/cg59
- 6.Zhang W, Doherty M, Arden N, Bannwarth B, Bijlsma J, Gunther KP et al (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). Ann Rheum Dis 64:669–681PubMedCrossRefGoogle Scholar
- 7.Jordan KM, Arden NK, Doherty M, Bannwarth B, Bijlsma JW, Dieppe P et al (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). Ann Rheum Dis 62:1145–1155PubMedPubMedCentralCrossRefGoogle Scholar
- 11.Riddle D, Stratford PW (2013) Body weight changes and corresponding changes in pain and function in persons with symptomatic knee osteoarthritis: a cohort study. Arthritis Care Res 65:15–22Google Scholar
- 12.Gudbergsen H, Boesen M, Lohmander LS, Christensen R, Henriksen M, Bartels EM et al (2012) Weight loss is effective for symptomatic relief in obese subjects with knee osteoarthritis independently of joint damage severity assessed by high-field MRI and radiography. Osteoarthr Cartil 20(6):495–502PubMedCrossRefGoogle Scholar
- 13.Body Mass Index. Available from: http://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthylifestyle/body-mass-index-bmi
- 18.Bartels EM, Lund H, Hagen KB, Dagfinrud H, Christensen R, Danneskiold-Samsøe B (2007) Aquatic exercise for the treatment of knee and hip osteoarthritis. Cochrane Database Syst Rev 17(4):CD005523Google Scholar
- 24.Atamaz FC, Durmaz B, Baydar M, Demircioglu OY, Iyiyapici A, Kuran B et al (2012) Comparison of the efficacy of transcutaneous electrical nerve stimulation, interferential currents, and shortwave diathermy in knee osteoarthritis: a double-blind, randomized, controlled, multicenter study. Arch Phys Med Rehabil 93(5):748–56PubMedCrossRefGoogle Scholar
- 30.Mizusaki IA, Peccin S, Gomes Silva KN, Paiva Teixeira LE, Abrahão MI, Fernandes M et al (2013) Effects of neuromuscular electrical stimulation combined with exercises versus an exercise program on the pain and the function in patients with knee osteoarthritis: a randomized controlled trial. Biomed Res Int. 2013:272018. https://doi.org/10.1155/2013/272018 CrossRefGoogle Scholar
- 35.Tiso RL, Tong-Ngork S, Fredlund KL (2010) Oral versus topical Ibuprofen for chronic knee pain: a prospective randomized pilot study. Pain Phys 13(5):457–67Google Scholar
- 36.Derry S, Moore RA, Rabbie R (2012) Topical NSAIDs for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev 12(9):CD007400Google Scholar
- 44.Zegels B, Crozes P, Uebelhart D, Bruyère O, Reginster JY (2013) Equivalence of a single dose (1200 mg) compared to a three-time a day dose (400 mg) of chondroitin 4&6 sulfate in patients with knee osteoarthritis. Results of a randomized double blind placebo controlled study. Osteoarthr Cartil 21(1): 22–7CrossRefGoogle Scholar
- 46.National Institute for Health and Care Excellence. NICE clinical guideline 177 (2014) Osteoarthritis: care and management in adults. Manchester: NICE; Available from: http://www.nice.org.uk/ guidance/cg177
- 47.Chou R, McDonagh MS, Nakamoto E, Griffin J (2011) Analgesics for osteoarthritis: an update of the 2006 comparative effectiveness. Rockville (MD): Agency for Healthcare Research and Quality (US) Report No: 11(12)-EHC076-EFGoogle Scholar
- 49.Coxib and traditional NSAID Trialists’ (CNT) Collaboration, Bhala N, Emberson J, Merhi A, Abramson S, Arber N et al (2013) Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet 382:769–779CrossRefGoogle Scholar
- 50.Assessment report for Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and cardiovascular risk EMA/696137/2012. Available from: http://www.ema.europa.eu
- 55.Chappell AS, Desaiah D, Liu-Seifert H, Zhang S, Skljarevski V, Belenkov Y, Brown JP (2011) A double-blind, randomized, placebo-controlled study of the efficacy and safety of duloxetine for the treatment of chronic pain due to osteoarthritis of the knee. Pain Pract 11:33–41PubMedCrossRefGoogle Scholar
- 66.Turpin KM, De Vincenzo A, Apps AM, Cooney T, MacKenzie MD, Chang R, Hunt MA (2012) Biomechanical and clinical outcomes with shock-absorbing insoles in patients with knee osteoarthritis: immediate effects and changes after 1 month of wear. Arch Phys Med Rehabil 93(3):503–508PubMedCrossRefGoogle Scholar
- 67.Brouwer RW, Huizinga MR, Duivenvoorden T, van Raaij TM, Verhagen AP, Bierma-Zeinstra SM, Verhaar JA (2014) Osteotomy for treating knee osteoarthritis. Cochrane Database Syst Rev 12:CD004019Google Scholar
- 69.Park KS, Choi JJ, Kim WU, Min JK, Park SH, Cho CS (2012) The efficacy of tramadol/acetaminophen combination tablets (Ultracet®) as add-on and maintenance therapy in knee osteoarthritis pain inadequately controlled by nonsteroidal antiinflammatory drug (NSAID). Clin Rheumatol 31(2):317–23PubMedCrossRefGoogle Scholar
- 70.Chandanwale AS, Sundar S, Latchoumibady K, Biswas S, Gabhane M, Naik M et al (2014) Efficacy and safety profile of combination of tramadol-diclofenac versus tramadol-paracetamol in patients with acute musculoskeletal conditions, postoperative pain, and acute flare of osteoarthritis and rheumatoid arthritis: a Phase III, 5-day open-label study. J Pain Res 12(7):455–63Google Scholar
- 71.daCosta BR, Nüesch E, Kasteler R, Husni E, Welch V, Rutjes AWS, Jüni P (2014) Oral or transdermal opioids for osteoarthritis of the knee or hip. Cochrane Database Syst Rev 9:CD003115Google Scholar
- 77.Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew MMoher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M et al (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. https://doi.org/10.1186/2046-4053-4-1 1;4:1.PubMedPubMedCentralCrossRefGoogle Scholar