Nonoperative Management Recommendations for Knee Osteoarthritis: A Review of Clinical Guidelines and Treatment Alternatives

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• 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 is among the leading causes of disability worldwide, imposing a substantial physical, psychological, and economic burden. Nonoperative management remains the cornerstone of initial care for patients before surgical considerations. This narrative review aims to synthesize current international guidelines and supporting evidence for both traditional and emerging nonoperative therapies, providing a pragmatic framework for clinical practice. Evidence consistently supports core interventions, such as patient education, self-management, weight reduction, and structured exercise. Pharmacologic adjuncts, including topical and oral nonsteroidal anti-inflammatory drugs (NSAIDs), may provide symptomatic relief, while intra-articular corticosteroids are appropriate in selected cases. More recent approaches, such as platelet-rich plasma, genicular nerve radiofrequency ablation, and genicular artery embolization, demonstrate early promise, though long-term comparative data remain limited. Optimal outcomes are achieved through patient-centered, multidisciplinary care models that address barriers, like poor adherence to exercise and limited access to weight-loss programs. This review was conducted via targeted PubMed searches using terms related to "knee osteoarthritis," "non-operative treatment," "guidelines," "exercise," "weight loss," "NSAIDs," "intra-articular corticost

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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