Guidelines for Managing Knee Osteoarthritis

Knee osteoarthritis, medically referred to as gonarthrosis, encompasses a spectrum of degenerative conditions affecting the knee joint. This condition is characterized by the progressive deterioration of articular cartilage, which involves not only the cartilage itself but also ligaments, bones, joint capsules, and surrounding muscles. Gonarthrosis is among the most prevalent degenerative joint disorders.

As the condition advances, it may lead to complete cartilage loss in the knee, often resulting in pain during movement and, in severe cases, joint stiffness that can significantly impair functionality. However, it's essential to note that not all individuals with observable radiological changes in their knees experience similar levels of pain or functional limitations. In fact, patients frequently exhibit alternating phases of inflammatory and non-inflammatory symptoms.

In many cases of progressive knee osteoarthritis, surgical intervention, including the potential need for a prosthetic joint, becomes necessary to preserve mobility. Therefore, individuals experiencing persistent knee pain coupled with reduced range of motion are advised to seek medical consultation promptly.

Early intervention can slow or potentially halt the progression of osteoarthritis. While a complete pharmacological cure remains elusive, treatment is primarily focused on alleviating symptoms to enhance the patient's quality of life. The recently updated S2k guidelines on gonarthrosis, published in 2024 under the auspices of the German Society for Orthopedics and Trauma Surgery (DGOU), offer an evidence-based overview of available therapeutic options. Notably, a new section addressing metamizole has been introduced, while the previous section on chondroitin sulfate has been removed.

Many associate osteoarthritis with age; however, the onset of gonarthrosis is influenced by various factors beyond mere aging. Genetic predispositions, age-related declines in regenerative capacity, mechanical stressors on the knee joint, metabolic influences, and localized inflammation all contribute to the development of osteoarthritis.

The likelihood of developing knee osteoarthritis increases significantly with age. Statistics indicate that approximately 48% of women and 31% of men over the age of 65 are affected by this condition. The prevalence of gonarthrosis has risen markedly in recent years and is expected to continue increasing. According to the guidelines' authors, nearly 45% of individuals are at risk of developing symptomatic knee osteoarthritis by the age of 85. This risk escalates with factors such as obesity and previous knee injuries.

As the population ages and the number of affected individuals grows, the social and medical implications of knee osteoarthritis are substantial. Understanding the guidelines for managing this condition is crucial for both patients and healthcare providers in effectively addressing the challenges posed by gonarthrosis.