LatinVisco: A latin american expert consensus on viscosupplementation for knee osteoarthritis

BACKGROUND: Osteoarthritis (OA) continues to rise worldwide, mainly driven by population aging, and represents one of the leading causes of pain and disability in older adults. Knee OA is the most prevalent form and constitutes a significant clinical and economic challenge. In response to this need, the LATINVISCO group brought together specialists from various Latin American countries to develop evidence-based recommendations on viscosupplementation (VS) and other intra-articular (IA) therapies. METHODS: Twenty-five experts in traumatology, orthopedics, rheumatology, and sports medicine participated. Fifteen questions were formulated using the PICO method, and a systematic search was performed in PubMed, Scopus, Cochrane, Scielo, and Elsevier, covering the last decade. Of the 396 studies identified, 57 highly relevant ones were selected. The GRADE scale was applied, and a modified Delphi method was used to reach consensus. RESULTS: Recent evidence confirms that intra-articular hyaluronic acid (HA) reduces pain, improves function, and has a favorable safety profile. VS is recommended in OA grades I-III and may be considered in grade IV. Platelet-rich plasma (PRP) showed superiority over VS in some parameters, while VS demonstrated additional usefulness in patellofemoral chondropathy and periarticular conditions. Likewise, VS showed good cost-effectiveness and safety in patients on anticoagulant or antiplatelet therapy. CONCLUSION: The LATINVISCO consensus provides updated recommendations adapted to the Latin American context, supporting VS as an effective, safe, and cost-effective intervention for knee OA. These guidelines facilitate therapeutic standardization and optimize clinical outcomes.