Rheumatology International

, Volume 38, Issue 8, pp 1315–1331 | Cite as

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

  • Tiraje Tuncer
  • Fatih Hasan CayEmail author
  • Lale Altan
  • Gulcan Gurer
  • Cahit Kacar
  • Suheda Ozcakir
  • Sahap Atik
  • Figen Ayhan
  • Berrin Durmaz
  • Nurten Eskiyurt
  • Hakan Genc
  • Yesim GokceKutsal
  • Rezzan Gunaydin
  • Simin Hepguler
  • Sami Hizmetli
  • Taciser Kaya
  • Yesim Kurtais
  • Merih Saridogan
  • Dilsad Sindel
  • Serap Sutbeyaz
  • Omer Faruk Sendur
  • Hatice Ugurlu
  • Zeliha Unlu


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.


Knee 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.

Ethical approval

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

Supplementary material

296_2018_4044_MOESM1_ESM.docx (15 kb)
Supplementary material 1 (DOCX 14 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School Of Medicine, Physical Medicine RehabilitationAkdeniz UniversityAntalyaTurkey
  2. 2.Antalya Training and Research Hospital, Physical Medicine Rehabilitation and RheumatologyUniversity of Health SciencesAntalyaTurkey
  3. 3.School of Medicine, Physical Medicine RehabilitationUludağ UniversityBursaTurkey
  4. 4.School of Medicine, Physical Medicine Rehabilitation and RheumatologyAdnan Menderes UniversityAydınTurkey
  5. 5.School Of Medicine, Physical Medicine Rehabilitation and RheumatologyAkdeniz UniversityAntalyaTurkey
  6. 6.School of Medicine, Orthopaedics and TraumatologyGazi UniversityAnkaraTurkey
  7. 7.Ankara Training and Research Hospital, Physical Medicine RehabilitationUniversity Of Health SciencesAnkaraTurkey
  8. 8.School of Medicine, Physical Medicine RehabilitationEge UniversityIzmirTurkey
  9. 9.Istanbul School of Medicine, Physical Medicine Rehabilitation (Retired)İstanbul UniversityIstanbulTurkey
  10. 10.School of Medicine, Physical Medicine RehabilitationHacettepe UniversityAnkaraTurkey
  11. 11.Physical Medicine RehabilitationMedical Park İzmir HospitalIzmirTurkey
  12. 12.School of Medicine, Physical Medicine Rehabilitation and Rheumatology Physical Medicine RehabilitationCumhuriyet UniversitySivasTurkey
  13. 13.Bozyaka Training and Research Hospital, Physical Medicine RehabilitationUniversity of Health SciencesIzmirTurkey
  14. 14.School of Medicine, Physical Medicine RehabilitationAnkara UniversityAnkaraTurkey
  15. 15.Cerrahpaşa School of Medicine, Physical Medicine Rehabilitationİstanbul UniversityIstanbulTurkey
  16. 16.İstanbul School of Medicine, Physical Medicine Rehabilitationİstanbul UniversityIstanbulTurkey
  17. 17.Kayseri Training and Research Hospital, Physical Medicine RehabilitationUniversity of Health SciencesKayseriTurkey
  18. 18.School of Medicine, Physical Medicine RehabilitationAdnan Menderes UniversityAydınTurkey
  19. 19.School of Medicine, Physical Medicine RehabilitationNecmettin Erbakan UniversityKonyaTurkey
  20. 20.School of Medicine, Physical Medicine RehabilitationCelal Bayar UniversityManisaTurkey

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