Table 2.
Level of Consensus on Retreatment after Success of Viscosupplementation.
| Issues on Retreatment after Success of Viscosupplementation | Level of Consensus | Agreement |
|
|---|---|---|---|
| Agree | Disagree | ||
| Retreatment with VS must be considered | |||
| Systematically every 6-12 months, even if patients remain asymptomatic | Strongly against | 2 | 8 |
| Only if pain returns to pretreatment levels | Strong against | 2 | 8 |
| Only from a certain level of pain (i.e., PASS) | Strongly in favor | 8 | 2 |
| As soon as pain occurs again | Strongly in favor | 9 | 1 |
| According to the patient’s wishes | Moderately in favor | 7 | 3 |
| Must we retreat systematically little symptomatic patients? | |||
| Yes | Weakly in favor | 6 | 4 |
| Every 3 months | Strongly against | 0 | 6 |
| Every 6 months | Strongly against | 1 | 5 |
| Every year | Strongly against | 1 | 5 |
| Yes but the time interval between 2 treatments must be adapted to the patient’s situation (i.e., age, anatomical severity, activities, etc.) | Unanimously in favor | 6 | 0 |
| Which of these clinical situations may push you into retreating patients? | |||
| Early stage of OA? | Strongly in favor | 9 | 1 |
| Advanced stage of OA? | Strongly against | 2 | 8 |
| Young age? | Strongly in favor | 9 | 1 |
| Elderly | Moderately against | 3 | 7 |
| Risk factors of rapid progression? | Strongly in favor | 9 | 1 |
| Sports practice (leisure)? | No consensus | 5 | 5 |
| Sports practice (professional)? | Strongly in favor | 9 | 1 |
| Contraindication to arthroplasty? | Moderately in favor | 7 | 3 |
| Severe comorbidities? | Strongly in favor | 8 | 2 |
| Does the chondroprotective properties of HA influence your decision to retreat asymptomatic or little symptomatic patients with HA? | Strongly in favor | 8 | 2 |
VS = viscosupplementation; OA = osteoarthritis; PASS = Patient’s Acceptable Symptom State; HA = hyaluronic acid.