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Viscosupplemenation (VS) is a symptomatic treatment of knee osteoarthritis. Although systematic reviews of its repeat use showed favorable benefit/risk ratio, no study has focused on the indication of retreatment.
To investigate the problem, a paper  has been published in Cartilage by the EUROVISCO Group. The EUROpean VIScosupplementation COnsensus Group is a working group of experts in osteoarthritis who regularly meets to exchange point of view, discuss, debate and establish recommendations on specific subjects related to viscosupplementation and osteoarthritis management.
The authors address the strategies for retreatment or not :
- in case of failure of a previous VS
- in case VS was previously successful
and propose a serie of questions leading to those recommendations.
The decision algorithm is intended to facilitate consideration of the therapeutic options, in patients with knee osteoarthritis previously treated with VS.
 “Decision Algorithms for the Retreatment with Viscosupplementation in Patients Suffering from Knee Osteoarthritis” https://www.ncbi.nlm.nih.gov/pubmed/29110511