Brazilian Consensus Statement on Viscosupplementation of the Hip (Cobravi-Q)

Abstract

Objective: The Brazilian Consensus on Hip Viscosupplementation aims to generate a referential and consensual source from the theoretical knowledge and clinical experience of specialists in the field. Methods: A multidisciplinary panel was formed with 15 specialists (sports medicine, orthopedists, physiatrists and rheumatologists), based on clinical and academic experience in the use of viscosupplementation of the hip. 12 statements were prepared, discussed and voted. Each panelist gave a value between 0 and 10 on a Likert scale, specifying their level of agreement with the statement. Results: The panel reached a consensus on several aspects of viscosupplementation of the hip, with emphasis on the following statements: best indication is for mild to moderate hip arthrosis; it may be indicated in severe osteoarthritis; results may vary according to the characteristics of the viscosupplement used; Viscosupplementation should not be performed as an isolated procedure, but in conjunction with other rehabilitation and pharmacological measures; best injection technique should be based on anatomical references coupled with imaging guidance; it is a cost-effective procedure. Conclusion: Viscosupplementation is a safe and effective therapy for hip osteoarthritis, even in severe cases. Guided injection is recommended. Level of Evidence V, Expert Opinion.

Efeitos da acupuntura no tratamento da dor crônica associada à osteoartrite do quadril: um ensaio clínico randomizado e controlado por placebo

“…O tratamento intra-articular com viscossuplementação é uma opção moderna para o tratamento da OA de quadril, que tem efeito analgésico, provavelmente por meio da diminuição da inflamação na articulação, porém não interfere na evolução natural da doença e nas alterações degenerativas da cartilagem 12 . Além disso, é considerada uma opção terapêutica eficaz e segura, mesmo em casos graves, recomendando-se a administração por métodos guiados 13 . Medicamentos como acetominofeno, duloxetina e tramadol são recomendados condicionalmente para a OA de quadril 2 .…”