EULAR recommendations for the management of knee osteoarthritis:: report of a task force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT)

被引:419
作者
Pendleton, A
Arden, N
Dougados, M
Doherty, M
Bannwarth, B
Bijlsma, JWJ
Cluzeau, F
Cooper, C
Dieppe, PA
Günther, KP
Hauselmann, HJ
Herrero-Beaumont, G
Kaklamanis, PM
Leeb, B
Lequesne, M
Lohmander, S
Mazieres, B
Mola, EM
Pavelka, K
Serni, U
Swoboda, B
Verbruggen, AA
Weseloh, G
Zimmermann-Gorska, I
机构
[1] Univ Paris 05, Hop Cochin, Inst Rhumatol, Serv Rhumatol B, F-75014 Paris, France
[2] Univ Nottingham, City Hosp, Nottingham NG5 1PB, England
[3] Musgrave Pk Hosp, Belfast, Antrim, North Ireland
[4] Southampton Gen Hosp, MRC, Epidemiol Unit, Southampton SO16 6YD, Hants, England
[5] Univ Bordeaux 2, Lab Therapeut, F-33076 Bordeaux, France
[6] Acad Ziekenhuis Utrecht, Afdeling Reumatol & Klin Immunol, NL-3508 GA Utrecht, Netherlands
[7] Univ London St Georges Hosp, Sch Med, Hlth Care Evaluat Unit, London SW17 0RE, England
[8] Univ Bristol, MRC Hlth Serv Res, Bristol BS8 2PR, Avon, England
[9] Ortho Klin RKU, D-89081 Ulm, Germany
[10] Ctr Rheumatol & Bone, Klin Pk, Hirslandengrp, CH-8038 Zurich, Switzerland
[11] Hop Conception, Serv Rhumatol, Madrid 28040, Spain
[12] Stockerau Hosp, Lower Austrian Ctr Rheumatol, A-2000 Stockerau, Austria
[13] Univ Lund Hosp, Dept Orthopaed, S-22185 Lund, Sweden
[14] CHU Rangueil, Serv Rhumatol, F-31054 Toulouse, France
[15] Hosp La Paz, Serv Reumatol, Madrid 28046, Spain
[16] Inst Rheumatol, Prague 12850 2, Czech Republic
[17] Ist Ortoped Toscano, Div Reumatol, Florence, Italy
[18] Waldkrankenhaus St Marian, Orthopad Univ Klin & Poliklin, Abt Rheuhopad Rheumatol, D-91054 Erlangen, Germany
[19] Univ Zuikenhuis, Rheumatol Unit, B-9000 Ghent, Belgium
[20] Karol Marcinskowski Univ Med Sci Poznan, Dept Rheumatol Rehabil, PL-61545 Poznan, Poland
关键词
D O I
10.1136/ard.59.12.936
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background-Osteoarthritis (OA) is the most common joint disease encountered throughout Europe. A task force for the EULAR Standing Committee for Clinical Trials met in 1998 to determine the methodological and logistical approach required for the development of evidence based guidelines for treatment of knee OA. The guidelines were restricted to cover all currently available treatments for knee OA diagnosed either clinically and/or radiographically affecting any compartment of the knee. Methods-The first stage was the selection of treatment modalities to be considered. The second stage comprised a search of the electronic databases Medline and Embase using a combination of subject headings and keywords. All European language publications in the form of systematic reviews, meta-analyses, randomised controlled trials, controlled trials, and observational studies were included. During stage three all the relevant studies were quality scored. The summary statistics for validated outcome measures, when available, were recorded and, where practical, the numbers needed to treat and the effect size for each treatment were calculated. In the fourth stage key clinical propositions were determined by expert consensus employing a Delphi approach. The final stage ranked these propositions according to the available evidence. A second set of propositions relating to a future research agenda was determined by expert consensus using a Delphi approach. Results-Over 2400 English language publications and 400 non-English language publications were identified. Seven hundred and forty four studies presented outcome data of the effects of specific treatments on knee OA. Quantitative analysis of treatment effect was possible in only 61 studies. Recommendations for the management of knee OA based on currently available data and expert opinion are presented. Proposals for a future research agenda are highlighted. Conclusions-These are the first clinical guidelines on knee OA to combine an evidence based approach and a consensus approach across a wide range of treatment modalities. It is apparent that certain clinical propositions are supported by substantial research based evidence, while others are not. There is thus an urgent need for future well designed trials to consider key clinical questions.
引用
收藏
页码:936 / 944
页数:9
相关论文
共 54 条
  • [21] The hazards of scoring the quality of clinical trials for meta-analysis
    Jüni, P
    Witschi, A
    Bloch, R
    Egger, M
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1999, 282 (11): : 1054 - 1060
  • [22] PAIN COPING SKILLS TRAINING IN THE MANAGEMENT OF OSTEOARTHRITIC KNEE PAIN - A COMPARATIVE-STUDY
    KEEFE, FJ
    CALDWELL, DS
    WILLIAMS, DA
    GIL, KM
    MITCHELL, D
    ROBERTSON, C
    MARTINEZ, S
    NUNLEY, J
    BECKHAM, JC
    CRISSON, JE
    HELMS, M
    [J]. BEHAVIOR THERAPY, 1990, 21 (01) : 49 - 62
  • [23] Keefe FJ, 1996, ARTHRIT CARE RES, V9, P279, DOI 10.1002/1529-0131(199608)9:4<279::AID-ANR1790090413>3.0.CO
  • [24] 2-6
  • [25] PAIN COPING SKILLS TRAINING IN THE MANAGEMENT OF OSTEOARTHRITIC KNEE PAIN-II - FOLLOW-UP RESULTS
    KEEFE, FJ
    CALDWELL, DS
    WILLIAMS, DA
    GIL, KM
    MITCHELL, D
    ROBERTSON, C
    MARTINEZ, S
    NUNLEY, J
    BECKHAM, JC
    HELMS, M
    [J]. BEHAVIOR THERAPY, 1990, 21 (04) : 435 - 447
  • [26] THE SWEDISH KNEE ARTHROPLASTY REGISTER - A NATIONWIDE STUDY OF 30,003 KNEES 1976-1992
    KNUTSON, K
    LEWOLD, S
    ROBERTSSON, O
    LIDGREN, L
    [J]. ACTA ORTHOPAEDICA SCANDINAVICA, 1994, 65 (04): : 375 - 386
  • [27] Kolarz G., 1995, European Journal of Rheumatology and Inflammation, V15, P39
  • [28] SUPERVISED FITNESS WALKING IN PATIENTS WITH OSTEOARTHRITIS OF THE KNEE - A RANDOMIZED, CONTROLLED TRIAL
    KOVAR, PA
    ALLEGRANTE, JP
    MACKENZIE, CR
    PETERSON, MGE
    GUTIN, B
    CHARLSON, ME
    [J]. ANNALS OF INTERNAL MEDICINE, 1992, 116 (07) : 529 - 534
  • [29] AN ASSESSMENT OF CLINICALLY USEFUL MEASURES OF THE CONSEQUENCES OF TREATMENT
    LAUPACIS, A
    SACKETT, DL
    ROBERTS, RS
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1988, 318 (26) : 1728 - 1733
  • [30] LEE P, 1985, CANADIAN MULTICENTER, V12, P544