2012+ACR+关于手部、髋部和膝部骨关节炎的非药物和药物治疗的建议.pdf

American College of Rheumatology 2012 Recommendations for the Use of Nonpharmacologic and Pharmacologic Therapies in Osteoarthritis of the Hand, Hip, and Knee MARC C. HOCHBERG, 1 ROY D. ALTMAN, 2 KARINE TOUPIN APRIL, 3 MARIA BENKHALTI, 3 GORDON GUYATT, 4 JESSIE MCGOWAN, 3 TANVEER TOWHEED, 5 VIVIAN WELCH, 3 GEORGE WELLS, 3 ANDPETER TUGWELL 3 Guidelines and recommendations developed and/or endorsed by the American College of Rheumatology (ACR) are intended to provide guidance for particular patterns of practice and not to dictate the care of a particular patient. The ACR considers adherence to these guidelines and recommenda- tions to be voluntary, with the ultimate determination regarding their application to be made by the physician in light of each patient’s individual cir- cumstances. Guidelines and recommendations are intended to promote beneficial or desirable outcomes but cannot guarantee any specific outcome. Guidelines and recommendations developed or endorsed by the ACR are subject to periodic revision as warranted by the evolution of medical knowl- edge, technology, and practice. The American College of Rheumatology is an independent, professional, medical and scientific society which does not guarantee, warrant, or endorse any commercial product or service. Objective.To update the American College of Rheumatology (ACR) 2000 recommendations for hip and knee osteoarthritis (OA) and develop new recommendations for hand OA. Methods.A list of pharmacologic and nonpharmacologic modalities commonly used to manage knee, hip, and hand OA as well as clinical scenarios representing patients with symptomatic hand, hip, and knee OA were generated. Systematic evidence-based literature reviews were conducted by a working group at the Institute of Population Health, University of Ottawa, and updated by ACR staff to include additions to bibliographic databases through December 31, 2010. The Grading of Recommendations Assessment, Development and Evaluation approach, a formal p