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      EFFECTIVENESS OF VISCOSUPPLEMENTATION IN THE TREATMENT OF HEMOPHILIC ARTHROPATHY: A SYSTEMATIC REVIEW Translated title: EFETIVIDADE DA VISCOSSUPLEMENTAÇÃO NO TRATAMENTO DA ARTROPATIA HEMOFÍLICA: UMA REVISÃO SISTEMÁTICA

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          ABSTRACT

          Objective:

          To describe the efficacy of using viscosupplementation in patients with hemophilic arthropathy (HA), on pain, limb functionality, and quality of life.

          Methods:

          A systematic review of the literature was performed following the PRISMA guidelines without limitations of language or year of publication. The search was performed on the following medical databases: PubMed, Cochrane Library, EMBASE, BVS/BIREME, Scopus, Web of Science, EBSCOhost, and PROQUEST in April 2020. The search used the following word: (hemophilia AND joint diseases) OR (haemophilic arthropathy OR hemophilic arthropathy) AND viscosupplementation.

          Results:

          The systematic review identified 127 articles, 10 of which were selected for data extraction and qualitative analysis. The 10 selected articles included 297 joints with HA in 177 hemophilic subjects. Our review showed positive results in alleviating pain and improving functional capacity, and quality of life. No major adverse effects were observed.

          Conclusion:

          There is a lack of scientific evidence regarding viscosupplementation with hyaluronic acid, but the results presented in this research suggest that it is an effective and safe therapeutic option to alleviate pain and improve functional capacity in patients with HA. Level of Evidence II, Systematic Review.

          RESUMO

          Objetivo:

          Descrever o uso da viscossuplementação com ácido hialurônico em pacientes com artropatia hemofílica (HA), sua eficácia na dor, a funcionalidade do membro e a qualidade de vida após sua aplicação.

          Métodos:

          Revisão sistemática da literatura (RSL) que seguiu as diretrizes PRISMA, sem limitação de idioma ou ano de publicação. A pesquisa foi realizada em abril de 2020 nas seguintes bases de dados médicas: PubMed, Cochrane Library, EMBASE, BVS/BIREME, Scopus, Web of Science, EBSCOhost e ProQuest. A estratégia de pesquisa foi: (hemofilia AND joint disease) OR (artropatia hemofílica OU artropatia hemofílica) E viscossuplementação.

          Resultados:

          A RSL identificou 127 artigos, dos quais 10 foram selecionados para extração de dados e análise qualitativa. Os 10 artigos selecionados incluíram 297 articulações com AH em 177 indivíduos hemofílicos. Nossa revisão mostrou resultados positivos na melhora da dor, na capacidade funcional e na qualidade de vida. Não foram observados efeitos adversos importantes.

          Conclusão:

          A evidência científica atual a respeito da viscossuplementação com ácido hialurônico é escassa, mas os resultados apresentados nesta pesquisa sugerem que é uma opção terapêutica eficaz e segura para diminuir a dor e melhorar a capacidade funcional em pacientes com AH. Nível de Evidência II, Revisão Sistemática.

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          Most cited references46

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          The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration.

          Systematic reviews and meta-analyses are essential to summarize evidence relating to efficacy and safety of health care interventions accurately and reliably. The clarity and transparency of these reports, however, is not optimal. Poor reporting of systematic reviews diminishes their value to clinicians, policy makers, and other users. Since the development of the QUOROM (QUality Of Reporting Of Meta-analysis) Statement--a reporting guideline published in 1999--there have been several conceptual, methodological, and practical advances regarding the conduct and reporting of systematic reviews and meta-analyses. Also, reviews of published systematic reviews have found that key information about these studies is often poorly reported. Realizing these issues, an international group that included experienced authors and methodologists developed PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) as an evolution of the original QUOROM guideline for systematic reviews and meta-analyses of evaluations of health care interventions. The PRISMA Statement consists of a 27-item checklist and a four-phase flow diagram. The checklist includes items deemed essential for transparent reporting of a systematic review. In this Explanation and Elaboration document, we explain the meaning and rationale for each checklist item. For each item, we include an example of good reporting and, where possible, references to relevant empirical studies and methodological literature. The PRISMA Statement, this document, and the associated Web site (http://www.prisma-statement.org/) should be helpful resources to improve reporting of systematic reviews and meta-analyses.
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            Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions

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              Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee.

              Within the context of a double blind randomized controlled parallel trial of 2 nonsteroidal antiinflammatory drugs, we validated WOMAC, a new multidimensional, self-administered health status instrument for patients with osteoarthritis of the hip or knee. The pain, stiffness and physical function subscales fulfil conventional criteria for face, content and construct validity, reliability, responsiveness and relative efficiency. WOMAC is a disease-specific purpose built high performance instrument for evaluative research in osteoarthritis clinical trials.
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                Author and article information

                Contributors
                Role: development of this articleRole: designed the researchRole: collatedRole: analyzed the dataRole: wrote the paperRole: approved the submitted paper
                Role: development of this articleRole: designed the researchRole: collatedRole: analyzed the dataRole: wrote the paperRole: approved the submitted paper
                Role: development of this articleRole: revised criticallyRole: gave final approval of the manuscriptRole: approved the submitted paper
                Role: development of this articleRole: revised criticallyRole: gave final approval of the manuscriptRole: approved the submitted paper
                Role: development of this articleRole: revised criticallyRole: gave final approval of the manuscriptRole: approved the submitted paper
                Role: development of this articleRole: revised criticallyRole: gave final approval of the manuscriptRole: approved the submitted paper
                Journal
                Acta Ortop Bras
                Acta Ortop Bras
                aob
                Acta Ortopedica Brasileira
                ATHA EDITORA
                1413-7852
                1809-4406
                18 December 2023
                2023
                : 31
                : 6
                : e271857
                Affiliations
                [1 ]Universidade Estadual de Campinas, Faculdade de Ciencias Medicas, Departamento de Ortopedia e Traumatologia, Campinas, SP, Brazil
                [2 ]Universidade Estadual de Campinas, Faculdade de Ciencias Medicas, Departamento de Neurologia e Neurocirurgia, Campinas, SP, Brazil
                [3 ]Universidade Estadual de Campinas, Centro de Hematologia e Hemoterapia, Unidade de Hemofilia “Claudio Luiz Pizzigatti Correa”, Campinas, SP, Brazil
                [4 ]Universidade Estadual de Campinas, Faculdade de Ciencias Medicas, Departamento de Medicina Interna, Campinas, SP, Brazil
                Author notes
                Correspondence: Samilly Conceição Maia Martins. Rua Carlos Gomes, 241, Campinas, SP, Brazil, 13083970. samilly.maia@ 123456hotmail.com

                MCO has received grants from BioMarin, Novo Nordisk, Pfizer, Sanofi, Roche, and Takeda, and has participated as speaker and/or in advisory boards sponsored by Bayer, BioMarin, Novo Nordisk, Pfizer, Roche, and Takeda. SCMM, EJA, MBS, GCC and RGP declare no potential conflict of interest related to this article.

                Author information
                http://orcid.org/0000-0001-8669-3896
                http://orcid.org/0000-0001-9071-4688
                http://orcid.org/0000-0003-4323-8281
                http://orcid.org/0000-0001-5938-0675
                http://orcid.org/0000-0001-7811-7354
                http://orcid.org/0000-0002-6064-2027
                Article
                00205
                10.1590/1413-785220233105e271857
                10726718
                38115879
                e784d75c-97ad-4908-baa3-046d7bf8c595

                This is an open-access article distributed under the terms of the Creative Commons Attribution License

                History
                : 07 February 2023
                : 28 April 2023
                Page count
                Figures: 1, Tables: 3, Equations: 0, References: 40
                Categories
                Original Article

                hyaluronic acid,viscosupplementation,hemarthrosis,pain management,arthropathy,hemophilia,ácido hialurônico,viscossuplementação,hemartrose,manejo da dor,artropatia,hemofilia

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