Table 1.

Issues on Viscosupplementation that Obtained a Unanimous Level of Consensus.

Issues	Level of Consensus (11/11= Unanimous)
Statements	• A good indication, based on both an accurate analysis of signs, symptoms and clinical history and a careful clinical examination may improve the chances of success of VS. • A good indication based on a precise analysis of the radiological features may improve the chances of success of VS. • A good technique of injection and/or the use of an imaging guidance may enhance the chances of success of VS. • Radiological severity (KL score IV vs. I-III) may influence the response of VS in the knee. • Radiological severity (KL score IV vs. I-III) may influence the response of VS in the hip.
Recommendations	• We recommend administering VS in the knee through a lateral patellofemoral route. • We recommend performing VS under fluoroscopy or ultrasound guidance in the hip. • We recommend performing VS under fluoroscopy or ultrasound guidance in the ankle.
Appropriateness for using VS in daily practice situations	• Patients with symptomatic, mild to moderate knee OA (JSN grade 0-2, KL I-III), with normal weight or moderate overweight (BMI < 30), not sufficiently improved by nonpharmacological interventions and analgesics/NSAIDs. • Patients with symptomatic, mild to moderate knee OA (JSN grade 0-2, KL I-III), with normal weight or moderate overweight (BMI < 30), with contraindication to analgesics/NSAIDs.

VS = viscosupplementation; JSN = joint space narrowing; KL = Kellgren-Lawrence score; OA = osteoarthritis; BMI = body mass index; NSAIDs = nonsteroidal anti-inflammatory drugs.