OPTIKNEE 2022: Consensus recommendations to optimise knee health after traumatic knee injury to prevent osteoarthritis
journal contribution
posted on 2025-05-21, 06:47 authored by JL Whittaker, Adam CulvenorAdam Culvenor, CB Juhl, B Berg, A Bricca, SR Filbay, P Holm, E Macri, AP Urhausen, Clare ArdernClare Ardern, Andrea BruderAndrea Bruder, GS Bullock, Allison EzzatAllison Ezzat, Michael GirdwoodMichael Girdwood, Melissa HaberfieldMelissa Haberfield, M Hughes, LH Ingelsrud, KM Khan, CY Le, JM Losciale, M Lundberg, M Miciak, BE Øiestad, Brooke PattersonBrooke Patterson, AM Räisänen, ST Skou, JB Thorlund, C Toomey, LK Truong, BLV Meer, Thomas WestThomas West, JJ Young, LS Lohmander, C Emery, MA Risberg, M Van Middelkoop, Ewa RoosEwa Roos, Kay CrossleyKay CrossleyThe goal of the OPTIKNEE consensus is to improve knee and overall health, to prevent osteoarthritis (OA) after a traumatic knee injury. The consensus followed a seven-step hybrid process. Expert groups conducted 7 systematic reviews to synthesise the current evidence and inform recommendations on the burden of knee injuries; risk factors for post-traumatic knee OA; rehabilitation to prevent post-traumatic knee OA; and patient-reported outcomes, muscle function and functional performance tests to monitor people at risk of post-traumatic knee OA. Draft consensus definitions, and clinical and research recommendations were generated, iteratively refined, and discussed at 6, tri-weekly, 2-hour videoconferencing meetings. After each meeting, items were finalised before the expert group (n=36) rated the level of appropriateness for each using a 9-point Likert scale, and recorded dissenting viewpoints through an anonymous online survey. Seven definitions, and 8 clinical recommendations (who to target, what to target and when, rehabilitation approach and interventions, what outcomes to monitor and how) and 6 research recommendations (research priorities, study design considerations, what outcomes to monitor and how) were voted on. All definitions and recommendations were rated appropriate (median appropriateness scores of 7-9) except for two subcomponents of one clinical recommendation, which were rated uncertain (median appropriateness score of 4.5-5.5). Varying levels of evidence supported each recommendation. Clinicians, patients, researchers and other stakeholders may use the definitions and recommendations to advocate for, guide, develop, test and implement person-centred evidence-based rehabilitation programmes following traumatic knee injury, and facilitate data synthesis to reduce the burden of knee post-traumatic knee OA.
Funding
JLW is supported by a Michael Smith Foundation for Health Research a Scholar Award (SCH-2020-0403) and an Arthritis Society STAR Career Development Award (STAR-19-0493). STS is supported by a program grant from Region Zealand (Exercise First) and two grants from the European Union’s Horizon 2020 research and innovation program, one from the European Research Council (MOBILIZE, grant agreement No 801790) and the other under grant agreement No 945377 (ESCAPE). CAE holds a Tier 1 Canada Research Chair. JLM is supported by the Arthritis Society. LKT is supported by a Canadian Institutes of Health Research Fellowship. AGC is supported by a National Health and Medical Research Council (NHMRC) of Australia Investigator Grant (GNT2008523). MG is supported by a NHMRC Post Graduate Scholarship (GNT1190882). EM was supported by a CIHR Banting Postdoctoral Fellowship. PH is supported by a program grant from Region Zealand (Exercise First). AB is supported by a program grant from the European Research Council (MOBILIZE, grant agreement No 801790). APU and MAR are supported by the National Institutes of Health, USA, Grant (R37HD37985). AME is supported by a CIHR Postdoctoral Fellowship. CMT is supported by a Health Research Board Emerging Investigator Award (EIA-2019-008). Initial priority theme setting for the OPTIKNEE consensus (https://bit.ly/OPTIKNEE) was supported by a Canadian Institutes of Health Research Planning and Dissemination Grant (principal investigator JLW #161821).
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