Modern approaches to the conservative treatment of osteoarthritis from the standpoint of evidence-based medicine

Abstract

Evidence-based medicine plays a leading role in modern clinical practice. The most well-known scales for evaluating the quality of evidence and recommendations based on them are OCEBM (Oxford Centre for Evidence-based Medicine), GRADE (Grading of Recommendations Assessment, Development and Evaluation), NICE (National Institute for Health and Care excellence). Objective: to acquaint readers with modern clinical guidelines for conservative treatment of osteoarthritis (OA), developed on the basis of the principles of evidence-based medicine. GRADE scale is widely used. The greatest authority among professionals have community leaders: ACR (American College of Rheumatologists), EULAR (European Antirheumatic League), OARSI (International Society of Osteoarthritis Researchers), AAOS (American Academy of Orthopedic Surgeons), ESCEO (European Society for Clinical and Economic Studies aspects of osteoporosis, osteoarthritis and musculoskeletal diseases). Their differences are due, in particular, to the use of different scales for assessing the levels of evidence and strength recommendations and relating to the use of SYSADOA (symptomatic slow-acting drugs for the treatment of OA), intra-articular injections of various drugs (corticosteroids, PRP, hyaluronic acid, etc.). The article presents strictly and conditionally recommended methods of conservative treatment of osteoarthritis of the hand, knee and hip joints. Conclusions: modern clinical guidelines are based on objective scales for evaluating evidence and recommendations, respectively, the probability of systematic errors is reduced. Therefore, prescribing according to them OA treatment regimes, we are sure that we choose the most effective among all available approaches.