CONSERVATIVE MANAGEMENT OF KNEE OSTEOARTHRITIS: A SYSTEMATIC REVIEW OF CONTEMPORARY APPROACHES

Introduction: Conservative treatment of knee osteoarthritis includes all non-surgical methods aimed at relieving symptoms and improving joint function. It involves pharmacotherapy, including nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics, as well as intra-articular injections such as corticosteroids, hyaluronic acid, or platelet-rich plasma. An important component of therapy is strengthening exercises for the thigh muscles, physical therapy, and the use of braces and insoles to offload the joint. Additionally, lifestyle modifications, including regular physical activity, help control symptoms and slow disease progression. Aim of the study: The aim of our study is to review the available literature on contemporary conservative treatment methods for gonarthrosis and to summarize current knowledge. We presented the mechanisms of action, clinical efficacy, and safety profile of various non-surgical interventions, including intra-articular injections, physical therapy, and exercise-based approaches. Methods and materials: We reviewed the literature available in the PubMed database using the following keywords: “Gonarthrosis”; “Knee osteoarthritis”; “Non-surgical treatment of knee osteoarthritis”; “Exercise therapy”; “NSAIDs”; “Duloxetine”; “Opioids”; ‘Platelet-rich plasma’; “Corticosteroid”; “ Hyaluronic acid”, “Intra-articular injection”. Conclusion: Comprehensive treatment of knee osteoarthritis is based on non-pharmacological methods, which form the foundation of therapy and demonstrate effectiveness comparable to pharmacological treatment, with a more favorable safety profile. Pharmacotherapy, including NSAIDs, can effectively alleviate symptoms, but its use is limited by the risk of adverse effects, particularly in elderly patients. Intra-articular injections, especially with hyaluronic acid and platelet-rich plasma (PRP), represent an important adjunct to symptomatic treatment, with PRP showing longer-lasting effects. Individualizing therapy is crucial for optimal treatment outcomes.