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EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis

Fernandes, L; Hagen, KB; Bijlsma, JWJ; Andreassen, O; Christensen, P; Conaghan, PG; Doherty, M; Geenen, R; Hammond, A; Kjeken, I; Lohmander, LS; Lund, H; Mallen, CD; Nava, T; Oliver, S; Pavelka, K; Pitsillidou, I; da Silva, JA; de la Torre, J; Zanoli, G; Vliet Vlieland, TPM


L Fernandes

KB Hagen

JWJ Bijlsma

O Andreassen

P Christensen

PG Conaghan

M Doherty

R Geenen

I Kjeken

LS Lohmander

H Lund

CD Mallen

T Nava

S Oliver

K Pavelka

I Pitsillidou

JA da Silva

J de la Torre

G Zanoli

TPM Vliet Vlieland


The objective was to develop evidence -based
recommendations and a research and educational
agenda for the non-pharmacological management of hip
and knee osteoarthritis (OA). The multidisciplinary task
force comprised 21 experts: nurses, occupational
therapists, physiotherapists, rheumatologists, orthopaedic
surgeons, general practitioner, psychologist, dietician,
clinical epidemiologist and patient representatives. After
a preliminary literature review, a first task force meeting
and five Delphi rounds, provisional recommendations
were formulated in order to perform a systematic review.
A literature search of Medline and eight other databases
was performed up to February 2012. Evidence was
graded in categories I–IV and agreement with the
recommendations was determined through scores from 0
(total disagreement) to 10 (total agreement). Eleven
evidence-based recommendations for the nonpharmacological
core management of hip and knee OA
were developed, concerning the following nine topics:
assessment, general approach, patient information and
education, lifestyle changes, exercise, weight loss,
assistive technology and adaptations, footwear and
work. The average level of agreement ranged between
8.0 and 9.1. The proposed research agenda included an
overall need for more research into non-pharmacological
interventions for hip OA, moderators to optimise
individualised treatment, healthy lifestyle with economic
evaluation and long-term follow-up, and the prevention
and reduction of work disability. Proposed educational
activities included the required skills to teach, initiate
and establish lifestyle changes. The 11 recommendations
provide guidance on the delivery of non-pharmacological
interventions to people with hip or knee OA. More
research and educational activities are needed,
particularly in the area of lifestyle changes.


Fernandes, L., Hagen, K., Bijlsma, J., Andreassen, O., Christensen, P., Conaghan, P., …Vliet Vlieland, T. (2013). EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Annals of the Rheumatic Diseases, 72(7), 1125-1135.

Journal Article Type Article
Publication Date Jan 1, 2013
Deposit Date Feb 19, 2015
Journal Annals of the Rheumatic Diseases (ARD)
Print ISSN 0003-4967
Electronic ISSN 1468-2060
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 72
Issue 7
Pages 1125-1135
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