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Practice Guideline
. 2024 Oct;67(7):101883.
doi: 10.1016/j.rehab.2024.101883. Epub 2024 Oct 28.

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

Yves-Marie Pers  1 , Christelle Nguyen  2 , Constance Borie  3 , Camille Daste  4 , Quentin Kirren  5 , Cyril Lopez  6 , Gaëlle Ouvrard  7 , Romane Ruscher  8 , Jean-Noël Argenson  9 , Sylvie Bardoux  10 , Laurence Baumann  11 , Francis Berenbaum  12 , Aymeric Binard  13 , Emmanuel Coudeyre  14 , Sébastien Czernichow  15 , Arnaud Dupeyron  16 , Marie-Christine Fabre  17 , Nathan Foulquier  18 , Caroline Gérard  19 , Vivien Hausberg  20 , Yves Henrotin  21 , Claude Jeandel  22 , François-Xavier Lesage  23 , Brigitte Liesse  24 , Didier Mainard  25 , Fabrice Michel  26 , Grégory Ninot  27 , Paul Ornetti  28 , Agnès Oude-Engberink  29 , Anne-Christine Rat  30 , Pascal Richette  31 , Alexandra Roren  32 , Philippe Thoumie  33 , Stéphane Walrand  34 , François Rannou  35 , Jérémie Sellam  36 ; Société Française de Rhumatologie and Société Française de Médecine Physique et de Réadaptation
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Free article
Practice Guideline

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

Yves-Marie Pers et al. Ann Phys Rehabil Med. 2024 Oct.
Free article

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.

Keywords: Knee osteoarthritis; Non-pharmacological interventions; Osteoarthritis; Recommendations; Treatments.

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Conflict of interest statement

Declaration of competing interest Each member of the SC submitted a declaration of interest prior to the meetings. Any potential conflicts of interest were managed by the SFR Ethics Commission before the 1st meeting. In the case of conflicts of interest, the participant(s) did not take part in discussions or vote. Some of the members of the SC declare conflicts of interest: i) PO: Proteor (consulting, hospitality, grants); ii) CN: Thuasne (consulting, hospitality); iii) YH: Wobenzym, Thuasne, Tilman (Consulting fee); iv) AD: Thuasne (consulting, hospitality). The other authors declare that they have no links of interest in connection with this work.

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