Author/Authors :
Constantino de Campos, Gustavoc Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil , de Sousa, Branco Eduardo Instituto de Nacional da Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, Brazil , César Hamdan, Paulo Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil , Scala de Almeida Júnior, Cyro Santa Casa de São Paulo - Faculty of Medicine, São Paulo, SP, Brazil , Martins Tieppo, Antonio Santa Casa de São Paulo - Faculty of Medicine, São Paulo, SP, Brazil , Uchôa de Rezende, Marcia Universidade de São Paulo - Faculdade de Medicina - Hospital das Clínicas - Department of Orthopedics and Traumatology (DOT/FMUSP), São Paulo, Brazil , Antunes do Amaral Alchaar, Adrieni Hospital Municipal Miguel Couto, Rio de Janeiro, RJ, Brazil , Bruno Pinheiro, Carlos Hospital Evangélico do Rio de Janeiro, Rio de Janeiro, RJ, Brazil , de Melo Carvalho Rocha, Eduardo nta Casa de São Paulo - Faculty of Medicine, São Paulo, SP, Brazil , Gonçalves Cunha, Fabiano Hospital Santa Paula, São Paulo, SP, Brazil , Pacheco, Ivan Hospital Moinhos de Vento - Porto Alegre, RS, Brazil , Sérgio Rossi Vieira, Mário Santa Casa de São Paulo, Faculty of Medicine, São Paulo, SP, Brazil , Figueira Antonio, Sílvio Hospital Estadual do Servidor Público, São Paulo, SP, Brazil , José Barcelos Menegassi, Zartur Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
Abstract :
Objective: The aim of this consensus statement on viscosupple-mentation is to serve as a reference document based on relevant literature and clinical experience in the treatment of knee osteoarthri-tis using an intra-articular injection of hyaluronic acid, covering key aspects such as clinical indications, effectiveness, and tolerability. Methods: A multidisciplinary panel including two sports medicine physicians, six orthopedists, four physiatrists, and two rheumatolo-gists were selected based on their clinical and academic experience of viscosupplementation. Sixteen statements were prepared and discussed, after which a vote was held. Each member of the panel gave a score between 0 and 10 on a Likert scale, specifying their level of agreement with the statement. Results: The panel reached a consensus on several issues. Specifically, the panel agreed that the best indication is for mild to moderate knee arthrosis; prior or concomitant use of intraarticular triamcinolone hexacetonide may optimize the effect of hyaluronic acid; viscosupplementation should not be performed as an isolated procedure but in conjunction with other rehabilitative and pharmacological measures; viscosupple-mentation has analgesic, anti-inflammatory, and chondroprotective effects; and viscosupplementation is cost-effective. Conclusion: This consensus statement provides clear information and guidance for both individuals and payers. Level of evidence V, Consensus statement.
