Conservative treatment of osteoarthritis – a modern analysis from the perspective of international clinical guidelines

Abstract

Background. Osteoarthritis is the most common degenerative joint disease, affecting elderly individuals and negatively impacting mobility and daily function. Conservative treatment aims to relieve symptoms, maintain joint function, slow disease progression, prevent complications, and improve quality of life. Objective(s). To evaluate modern conservative treatment approaches for osteoarthritis based on disease stage, in line with international and national clinical guidelines, with emphasis on evidence-based methods. Materials and methods. A review of updated clinical guidelines: EULAR (2019), OARSI (2020), and the National Clinical Protocol for Osteoarthritis (2018), enabled the detailed analysis of modern conservative treatment strategies. Kellgren-Lawrence radiological classification, WOMAC, VAS, and the 6-minute walk test were used for functional evaluation. Results. Stages I–II (early): focus on progression prevention through physical exercise, weight reduction, orthoses, paracetamol (max 3g/24h), topical anti-inflammatory drugs, chondroprotectors (min 6 months), and intra-articular hyaluronic acid injections (<65 years, without synovitis). Stage III (intermediate): systemic NSAIDs (meloxicam), intraarticular corticosteroid injections, continuation of adapted exercise programs, cane support, and physiotherapy. Stage IV (advanced): pain control with NSAIDs/opioids, intra-articular platelet-rich plasma or corticosteroids, psychological support, orthopedic devices, and preparation for joint arthroplasty. Conclusion(s). Conservative treatment of osteoarthritis requires an individualized approach based on disease stage and combining pharmacological and non-pharmacological methods. Adapting guidelines to each patient and ensuring active involvement improves treatment effectiveness and quality of life.