Management of Knee OsteoArthritis(KOA) is improving:A scoping review and quality appraisal of Clinical Practice Guidelines for KOA using the AGREE II and RIGHT

Abstract Background : Clinical practice guidelines (CPGs) are essential in healthcare, but their quality varies. This study aims to analyze 18 high-quality CPGs for knee osteoarthritis (KOA), identify areas for improvement, and establish common recommendations from contemporary CPGs for effective KOA management. Methods: We systematically searched guideline websites and databases until June 30, 2023, for KOA-related guidelines. Two independent reviewers assessed these using AGREE II and RIGHT checklists. The intra-class correlation coefficient (ICC) evaluated reviewer agreement, and recommendations and evidence levels were summarized. Results: We analyzed 18 Clinical Practice Guidelines (CPGs) from 1,411 records. Most were from China and the USA, published from 2016 to 2022, with 44.44% updates. Methodological quality was reliable, with 14 CPGs "recommended," but three had low "editorial independence" scores. Reporting quality ranged from 41.43–95.71%, with 66.66% scoring ≥ 80%. Recommendations included conservative measures, Tai Chi, Yoga, cane use, and various complementary and alternative medicines. Topical NSAIDs, oral NSAIDs, and intra-articular glucocorticoids were favored. Foreign guidelines stressed shared decision-making and patient preferences in KOA management. Conclusions: Over half of KOA CPGs are of good quality. However, there's substantial methodological variation and reporting quality gaps. Future efforts should enhance both. Our research supports a core set of interventions, including education, exercise, weight management, and personalized NSAID use, for evidence-based KOA practice and guideline development