ADVANCES IN NON-SURGICAL MANAGEMENT OF GONARTHROSIS: A SYSTEMATIC REVIEW

Abstract

Objectives: Knee osteoarthritis (KOA) is typically the result of wear and tear andprogressive loss of articular cartilage and may eventually lead to disability. Treatment forKOA begins with conservative methods and progresses to surgical treatmentoptions when conservative treatment fails. This systematic review aims to highlight the latestadvancements in non-surgical interventions to improve the management of this commonmusculoskeletal disorder. Methods: A comprehensive search of sources available in both English and Frenchencompassing various databases such as PubMed, Google Scholar, and relevant medicaljournals in addition to recommendations provided by prominent organizations(EULAR, ACR, SFR, SOFMER, OARSI, ESCEO, NICE, PANLAR, AAOS). Inclusion criteria were good quality systematic reviews, meta-analyses, practice guidelinesexcludingsurgicalKOA treatment. Results:We thoroughly examined a large set of 545 articles and meticulously selected 117 for detailed analysis. This carefully selected set comprised randomized controlled trials, consensus statements, international guidelines, systematic reviews, meta-analyses, cohort studies, and reviews. Qualitative synthesis revealed widely approved nonpharmacological therapies such as information/education programs, weight loss, and physicalactivity. Most agreed on pharmacological therapies were oral and local NSAIDs, Paracetamol, and intra articular corticosteroid injection. Other treatment options were subject to controversy. Conclusion:Various options are available for the treatment of KOA. However, KOA remains a commonglobal health challenge, affecting millions and compromising the quality of life through pain, functional limitations, and associated morbidities. A comprehensive and personalized approach seems crucial in order to reduce pain, improve knee function over the long term.