Conservative management of knee osteoarthritis in Primary Health Care: A literature review
DOI:
https://doi.org/10.62827/fb.v26i6.1124Keywords:
Osteoarthritis; Primary Health Care; Physical Therapy Modalities; Exercise Therapy; Patient Compliance.Abstract
Introduction: Knee osteoarthritis (OA) is a prevalent chronic condition that has a significant functional and economic impact. Although international guidelines recommend conservative management as first-line treatment, its application in primary health care (PHC) remains a challenge. Objective: Recent evidence on the effectiveness, adherence, and barriers related to the non-surgical management of knee osteoarthritis in primary health care was synthesized. Methods: Literature review in the PubMed (MEDLINE) database, covering 2018-2025. Randomized clinical trials and observational studies that evaluated conservative interventions (exercise, education, self-management) in adults and older adults with knee OA in PHC were included. Methodological quality was examined using the PEDro and Newcastle-Ottawa scales. Results: Sixteen studies were included. A discrepancy between evidence and practice was observed: although recommendations prioritize exercise and education, such strategies remain underutilized in PHC, with pharmacotherapy predominating. Structured exercise and education programs, in face-to-face or digital formats, demonstrated consistent effectiveness in reducing pain and improving function. Adherence stood out as the main determinant of clinical response, but was often limited by kinesiophobia, pain flare-ups, and lack of continuous monitoring. Conclusion: Structured care models that integrate education and exercise are effective in PHC, but their implementation is hampered by barriers to adherence and clinical inertia. The adoption of digital technologies and attention to appropriate exercise dosage emerge as essential strategies for optimizing outcomes and reducing the need for early surgical interventions.
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