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A decision-making tool to prescribe knee orthoses in daily practice for patients with osteoarthritis

OBJECTIVE: To develop a decision-making tool (DMT) to facilitate the prescription
of knee orthoses for patients with osteoarthritis (OA) in daily practice.
METHODS: A steering committee gathered a multidisciplinary task force experienced
in OA management/clinical research. Two members performed a literature review
with qualitative analysis of the highest-quality randomized controlled trials and
practice guidelines to confirm evidence concerning knee orthosis for OA. A first
DMT draft was presented to the task force in a 1-day meeting in January 2016. The
first version of the DMT was criticized and discussed regarding everyday practice
issues. Every step was discussed and amended until consensus agreement was
achieved within the task force. Then 4 successive consultation rounds occurred by
electronic communication, first with primary- and secondary-care physicians, then
with international experts. All corrections and suggestions by each member were
shared with the rest of the task force and included to reach final consensus. The
final version was validated by the steering committee. RESULTS: The definition
and indication of several types of knee orthoses (sleeve, patello-femoral, hinged
or unicompartmental offloading braces) were detailed.
Orthoses may be proposed in
addition to first-line non-pharmacological treatment if patient acceptance is
considered good. At every step, a specific clinical assessment is needed.
DISCUSSION/CONCLUSION: Based on the latest high-level evidence, practice
guidelines, and an expert panel, a DMT to facilitate daily practice prescription
of knee orthoses for OA patients was designed. An evaluation of DMT
implementation in a wide range of health professionals is still needed.
CI - Copyright (c) 2018 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.

Langue : ANGLAIS

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