Pubblicate le nuove linee guida dell' American Academy of Orthopaedic Surgeons con importanti novità in merito all'utilizzo della viscosupplementazione del ginocchio. L'uso di acido ialuronico per i pazienti con osteoartrosi sintomatica del ginocchio non è raccomandato così come altri interventi già messi in dubbio in passato.
Recommended Treatments
Not Recommended Treatments
Equivocal/Inconclusive Recommendations
Per approfondimenti:
The American Academy of Orthopaedic Surgeons (AAOS) Clinical practice guideline (CPG) on the treatment of osteoarthritis of the knee (2013)
Recommended Treatments
- We recommend that patients with symptomatic osteoarthritis of the knee participate in self-management programs, strengthening, low-impact aerobic exercises, and neuromuscular education; and engage in physical activity consistent with national guidelines. [Strong]
- We recommend nonsteroidal anti-inflammatory drugs (NSAIDs; oral or topical) or Tramadol for patients with symptomatic osteoarthritis of the knee. [Strong]
- We suggest weight loss for patients with symptomatic osteoarthritis of the knee and a BMI ≥25. [Moderate]
Not Recommended Treatments
- We cannot recommend using hyaluronic acid for patients with symptomatic osteoarthritis of the knee. [Strong]
- We cannot recommend using glucosamine and chondroitin for patients with symptomatic osteoarthritis of the knee. [Strong]
- We cannot recommend using acupuncture in patients with symptomatic osteoarthritis of the knee. [Strong]
- We cannot recommend performing arthroscopy with lavage and/or debridement in patients with a primary diagnosis of symptomatic osteoarthritis of the knee. [Strong]
- We cannot suggest that the practitioner use needle lavage for patients with symptomatic osteoarthritis of the knee. [Moderate]
- We cannot suggest that lateral wedge insoles be used for patients with symptomatic medial compartment osteoarthritis of the knee. [Moderate]
- In the absence of reliable evidence, it is the opinion of the work group not to use the free-floating (un-fixed) interpositional device in patients with symptomatic medial compartment osteoarthritis of the knee. [Consensus]
Equivocal/Inconclusive Recommendations
- We are unable to recommend for or against the use of acetaminophen, opioids, or pain patches for patients with symptomatic osteoarthritis of the knee. [Inconclusive]
- We are unable to recommend for or against the use of intraarticular (IA) corticosteroids for patients with symptomatic osteoarthritis of the knee. [Inconclusive]
- We are unable to recommend for or against growth factor injections and/or platelet rich plasma for patients with symptomatic osteoarthritis of the knee. [Inconclusive]
- We are unable to recommend for or against manual therapy in patients with symptomatic osteoarthritis of the knee. [Inconclusive]
- We are unable to recommend for or against the use of physical agents (including electrotherapeutic modalities) in patients with symptomatic osteoarthritis of the knee. [Inconclusive]
- We are unable to recommend for or against arthroscopic partial meniscectomy in patients with osteoarthritis of the knee with a torn meniscus. [Inconclusive]
- We are unable to recommend for or against the use of a valgus directing force brace (medial compartment unloader) for patients with symptomatic osteoarthritis of the knee. [Inconclusive]
- The practitioner might perform a valgus producing proximal tibial osteotomy in patients with symptomatic medial compartment osteoarthritis of the knee. [Limited]
Per approfondimenti:
The American Academy of Orthopaedic Surgeons (AAOS) Clinical practice guideline (CPG) on the treatment of osteoarthritis of the knee (2013)