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2017 update of the Turkish League Against Rheumatism (TLAR) evidence-based recommendations for the management of knee osteoarthritis

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Abstract

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.

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Acknowledgements

We extend special thanks to Dr. Sevcan Uğur for her valuable scientific contribution during the reduction process of the manuscript.

Author information

Authors and Affiliations

  1. School Of Medicine, Physical Medicine Rehabilitation, Akdeniz University, Antalya, Turkey

    Tiraje Tuncer

  2. Antalya Training and Research Hospital, Physical Medicine Rehabilitation and Rheumatology, University of Health Sciences, Antalya, Turkey

    Fatih Hasan Cay

  3. School of Medicine, Physical Medicine Rehabilitation, Uludağ University, Bursa, Turkey

    Lale Altan & Suheda Ozcakir

  4. School of Medicine, Physical Medicine Rehabilitation and Rheumatology, Adnan Menderes University, Aydın, Turkey

    Gulcan Gurer

  5. School Of Medicine, Physical Medicine Rehabilitation and Rheumatology, Akdeniz University, Antalya, Turkey

    Cahit Kacar

  6. School of Medicine, Orthopaedics and Traumatology, Gazi University, Ankara, Turkey

    Sahap Atik

  7. Ankara Training and Research Hospital, Physical Medicine Rehabilitation, University Of Health Sciences, Ankara, Turkey

    Figen Ayhan & Hakan Genc

  8. School of Medicine, Physical Medicine Rehabilitation, Ege University, Izmir, Turkey

    Berrin Durmaz & Simin Hepguler

  9. Istanbul School of Medicine, Physical Medicine Rehabilitation (Retired), İstanbul University, Istanbul, Turkey

    Nurten Eskiyurt

  10. School of Medicine, Physical Medicine Rehabilitation, Hacettepe University, Ankara, Turkey

    Yesim GokceKutsal

  11. Physical Medicine Rehabilitation, Medical Park İzmir Hospital, Izmir, Turkey

    Rezzan Gunaydin

  12. School of Medicine, Physical Medicine Rehabilitation and Rheumatology Physical Medicine Rehabilitation, Cumhuriyet University, Sivas, Turkey

    Sami Hizmetli

  13. Bozyaka Training and Research Hospital, Physical Medicine Rehabilitation, University of Health Sciences, Izmir, Turkey

    Taciser Kaya

  14. School of Medicine, Physical Medicine Rehabilitation, Ankara University, Ankara, Turkey

    Yesim Kurtais

  15. Cerrahpaşa School of Medicine, Physical Medicine Rehabilitation, İstanbul University, Istanbul, Turkey

    Merih Saridogan

  16. İstanbul School of Medicine, Physical Medicine Rehabilitation, İstanbul University, Istanbul, Turkey

    Dilsad Sindel

  17. Kayseri Training and Research Hospital, Physical Medicine Rehabilitation, University of Health Sciences, Kayseri, Turkey

    Serap Sutbeyaz

  18. School of Medicine, Physical Medicine Rehabilitation, Adnan Menderes University, Aydın, Turkey

    Omer Faruk Sendur

  19. School of Medicine, Physical Medicine Rehabilitation, Necmettin Erbakan University, Konya, Turkey

    Hatice Ugurlu

  20. School of Medicine, Physical Medicine Rehabilitation, Celal Bayar University, Manisa, Turkey

    Zeliha Unlu

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  1. Tiraje Tuncer
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  2. Fatih Hasan Cay
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Correspondence to Fatih Hasan Cay.

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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.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Tuncer, T., Cay, F.H., Altan, L. et al. 2017 update of the Turkish League Against Rheumatism (TLAR) evidence-based recommendations for the management of knee osteoarthritis. Rheumatol Int 38, 1315–1331 (2018). https://doi.org/10.1007/s00296-018-4044-y

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  • DOI: https://doi.org/10.1007/s00296-018-4044-y

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