Evolving Strategies for Knee Osteoarthritis: A Narrative Review of Integrated Rehabilitation, Pharmacologic, and Joint-Preserving Interventions

Several human studies show positive signals, while research methods and sample sizes continue to develop.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Knee osteoarthritis (KOA) is a primary driver of global disability, currently affecting over 365 million adults, with projections suggesting a 74.9% increase by 2050. Conventional clinical practice often prioritizes end-stage surgical outcomes while neglecting systematic, early-stage interventions designed to arrest disease progression. To ensure a robust synthesis of evidence, we conducted a systematic search of PubMed, Embase, and Web of Science (2020-2025) for high-quality clinical trials, meta-analyses, and guidelines. These selected sources were synthesized to identify the latest advancements in KOA management. This narrative review evaluates the clinical transition from reactive, surgery-centric models to a proactive, integrated framework to mitigate the profound socioeconomic burden and functional decline associated with the disease. We synthesized evidence across non-pharmacological rehabilitation, pharmacotherapy, and advanced joint-preserving surgeries, emphasizing optimal intervention windows and stage-specific mechanobiological requirements. Current "one-size-fits-all" approaches often fail to bridge the gap between initial conservative care and radical arthroplasty. Evidence indicates that while conservative treatments offer symptomatic relief, the strategic incorporation of joint-preserving surgeries - targeted at biomechanical realignment - is critical to bridge

Evidence level

Several human studies show positive signals, while research methods and sample sizes continue to develop.

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