Recommendations from the of the French Societies of Rheumatology and Physical Medicine and Rehabilitation on the non-pharmacological management of knee osteoarthritis - 16/08/24

Doi : 10.1016/j.rehab.2024.101883

Yves-Marie PERS ^1,^⁎ , Christelle NGUYEN ^2,^3,⁴ , Constance BORIE ⁵ , Camille DASTE ^2,^3,⁶ , Quentin KIRREN ^2,³ , Cyril LOPEZ ⁷ , Gaëlle OUVRARD ⁸ , Romane RUSCHER ¹ , Jean-Noël ARGENSON ⁹ , Sylvie BARDOUX ¹⁰ , Laurence BAUMANN ² , Francis BERENBAUM ¹¹ , Aymeric BINARD ¹² , Emmanuel COUDEYRE ¹⁰ , Sébastien CZERNICHOW ^13,¹⁴ , Arnaud DUPEYRON ^15,^16,¹⁷ , Marie-Christine FABRE ¹⁸ , Nathan FOULQUIER ^19,²⁰ , Caroline GÉRARD ³ , Vivien HAUSBERG ²¹ , Yves HENROTIN ^22,^22.1,^22.2 , Claude JEANDEL ²³ , François-Xavier LESAGE ⁷ , Brigitte LIESSE ¹⁸ , Didier MAINARD ^24,²⁵ , Fabrice MICHEL ^26,²⁷ , Grégory NINOT ⁷ , Paul ORNETTI ^28,^29,³⁰ , Agnès OUDE-ENGBERINK ⁷ , Anne-Christine RAT ^31,³² , Pascal RICHETTE ³³ , Alexandra ROREN ^2,^3,⁶ , Philippe THOUMIE ³⁴ , Stéphane WALRAND ³⁵ , François RANNOU ^2,^3,^4,^{^{#
co-authorship}} , Jérémie SELLAM ^11,^{^{#
co-authorship}}
on behalf of
Société Française de Rhumatologie and Société Française de Médecine Physique et de Réadaptation
¹ IRMB, University of Montpellier, INSERM, Clinical immunology and osteoarticular diseases Therapeutic Unit, Lapeyronie University Hospital, CHU Montpellier, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier CEDEX 05, France
² Université Paris Cité, Faculté de Santé, UFR de Médecine, 15, rue de l’école de médecine, 75006 Paris, France
³ AP-HP.Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, 27 rue du Faubourg Saint-Jacques 75014 Paris, France
⁴ INSERM UMR-S 1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs (T3S), Campus Saint-Germain-des-Prés, 45 rue des Saints-Pères, 75006 Paris, France
⁵ Université Clermont Auvergne, Service de Santé Universitaire, 25 rue Etienne Dolet, 63000, Clermont-Ferrand, France
⁶ INSERM UMR-S 1153, Centre de Recherche Épidémiologie et Statistique, ECaMO Team, 27 rue du Faubourg Saint-Jacques 75014 Paris, France
⁷ Desbrest Institute of Epidemiology and Public Health, UMR 1318 INSERM - University of Montpellier – INRIA, 641 avenue Giraud, 34093 Montpellier, France
⁸ Service de Neuro-orthopédie, Assistance Publique Hôpitaux de Paris, Sorbonne Université, Rothschild Hospital, 5 rue Santerre 75012 Paris, France
⁹ Aix-Marseille University, AP-HM, CNRS, ISM, Sainte-Marguerite Hospital, Institute for Locomotion, Department of Orthopedics and Traumatology, 249 Bd de Sainte-Marguerite, 13009 Marseille, France
¹⁰ Service de Médecine Physique et de Réadaptation, CHU Clermont-Ferrand, Université Clermont Auvergne, INRAE, UNH, 58 rue Montalembert, 63000 Clermont–Ferrand, France
¹¹ Department of Rheumatology, Saint-Antoine Hospital, Assistance Publique-Hopitaux de Paris, Sorbonne Université, Inserm UMRS_938, FHU PaCeMM Paris, 184 rue du Faubourg Saint-Antoine, 75012 Paris, France
¹² Department of Rheumatology, CHU de la Cavale-Blanche, 29609 Bd Tanguy Prigent, 29100 Brest, France
¹³ Université Paris Cité, INSERM, UMR1153, Methods Team, Epidemiology and Biostatistics Sorbonne Paris Cité Center, 27 rue du Faubourg Saint-Jacques 75014 Paris, France
¹⁴ Service de nutrition, centre spécialisé Obésité, APHP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France
¹⁵ Université Montpellier, Faculté de Médecine, 641 Avenue du Doyen Gaston Giraud, 34295 Montpellier, France
¹⁶ Service de Médecine Physique et de Réadaptation, CHU Nîmes, Univ Montpellier, 4 rue du Professeur Robert Debré, 30029 Nîmes, France
¹⁷ EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, 700 Avenue du Pic Saint-Loup, 34090 Montpellier, France
¹⁸ AFLAR, Association Française de Lutte Anti-Rhumatismale, 2 rue Bourgon, 75013 Paris, France
¹⁹ LBAI, UMR1227, Univ Brest, Inserm, 9 rue Felix Le Dantec, 29200 Brest, France
²⁰ DDS, CHU de Brest, 2 Avenue Foch, 29200 Brest, France
²¹ Kinésithérapeute Ostéopathe liberal, 107 rue Andy Wharol, 34000 Montpellier, France
²² MusckuloSKeletal Innovative research lab, Center for Interdisciplinary Research on Medicines, Department of Physical Activity and Rehabilitation Sciences, University of Liège, Liège, Belgium
^22.1 Department of Physical Therapy and Functional Rehabilitation, Vivalia, Marche-en-Famenne, Belgium
^22.2 The Osteoarthritis Foundation, Boncelles, Pl du Vingt Août 7, 4000 Liège, Belgium
²³ Directeur de l'Ecole de Gériatrie et Gérontologie, Université de Montpellier, 641 Avenue du Doyen Gaston Giraud, 34295 Montpellier, France
²⁴ Université de Lorraine, CNRS, IMoPA, 9 Av de la Forêt de Haye, 54500 Vandœuvre-lès-Nancy, France
²⁵ Service de Chirurgie Orthopédique, Traumatologique et Arthroscopique, CHRU Nancy, 29 Av du maréchal de Lattre de Tassigny, CO 60034, 54035 Nancy, France
²⁶ Service de Médecine Physique et de Réadaptation, CHU Jean Minjoz, 3 Bd Alexandre Fleming, 25000 Besançon, France
²⁷ Laboratoire de Nanomédecine, Imagerie, Thérapeutique, Université de Franche Comté, 16 route de Gray, 25030 Besançon, France
²⁸ INSERM, CIC 1432, Module Plurithématique, Plateforme d'Investigation Technologique, 2 Bd Maréchal de Lattre de Tassigny, 21000 Dijon, France
²⁹ INSERM, UMR1093-CAPS, Université Bourgogne Franche-Comté, UFR des Sciences du Sport, 3 allée des Stades Universitaires, 21078 Dijon, France
³⁰ Rheumatology Department, CHU Dijon-Bourgogne, 2 Bd Maréchal de Lattre de Tassigny, 21000 Dijon, France
³¹ Caen Normandie University, INSERM, U1075 COMETE, 2 rue des Rochambelles, 14032 Caen, France
³² Rheumatology Department, University Hospital Center Caen, Av de la Côte de Nacre, 14000 Caen, France
³³ Department of Rheumatology, Lariboisière Hospital, AP-HP, Université de Paris, INSERM U1132, 2 rue Ambroise Paré, 75010 Paris, France
³⁴ Service de Médecine Physique et Réadaptation, Assistance Publique Hôpitaux de Paris, Rothschild Hospital and Sorbonne University Agathe INSERM U1150, 5 rue Santerre, 75012 Paris, France
³⁵ Université Clermont Auvergne, CHU Clermont-Ferrand, INRAE, UNH, 49 Bd François Mitterrand, 63001 Clermont–Ferrand, France

^⁎Corresponding author: Yves-Marie PERS, IRMB, University of Montpellier, INSERM, CHU Montpellier, Clinical immunology and osteoarticular diseases Therapeutic Unit, Lapeyronie University Hospital, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier CEDEX 05, France, Tel: +33 4 67 33 72 31 73 - Fax: +33 4 67 33 72 27IRMBUniversity of MontpellierINSERM, CHU Montpellier, Clinical immunology and osteoarticular diseases Therapeutic UnitLapeyronie University Hospital371 Avenue du Doyen Gaston Giraud, 34295 Montpellier CEDEX 05France

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ABSTRACT

Background

Although non-pharmacological therapies for knee osteoarthritis (OA) are essential pillars of care, they are often poorly considered and inconsistently applied.

Objectives

Under the umbrella of the French Society of Rheumatology (SFR) and the French Society of Physical Medicine and Rehabilitation (SOFMER), we aimed to establish consensual recommendations for the non-pharmacological management of people with knee OA.

Methods

A group of fellows performed a systematic literature review on the efficacy and safety of non-pharmacological modalities (up to October 2021). The fellows then took part in discussions with a multidisciplinary group of experts to draft a list of recommendations. The list was then submitted to an independent reading committee who rated their level of agreement with each recommendation. Each recommendation was assigned a strength of recommendation and a level of evidence.

Results

Five general principles were unanimously accepted: (A) the need to combine non-pharmacological and pharmacological measures; (B) the need for personalized management; (C) the need to promote adherence; (D) the need for adapted physical activity; and (E) the need for person-centered education. Specific positive or negative recommendations were defined for 11 modalities: (1) unloading knee brace; (2) kinesiotaping or knee sleeves; (3) shoes and/or insoles; (4) using a cane; (5) physical exercise program; (6) joint mobilization; (7) electro- or thermo-therapy; (8) acupuncture; (9) weight loss; (10) thermal spa therapy; and (11) workplace accommodation.

Conclusions

These SFR/SOFMER recommendations provide important and consensual knowledge to assist health professionals in decision-making for non-pharmacological treatments for knee OA

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Keywords : osteoarthritis, knee osteoarthritis, treatments, recommendations, non-pharmacological interventions

LIST OF ABBREVIATIONS : ACR, APA, BMI, CBT, ESCEO, EULAR, HAS, LoE, OA, OARSI, PA, PRM, RCT, SC, SFR, SOFMER, TENS, WG