НЕОПЕРАТИВНИ МЕТОДИ В ЛЕЧЕНИЕТО НА КОЛЯННАТА ОСТЕОАРТРОЗА
NON-OPERATIVE METHODS IN THE TREATMENT OF KNEE OSTEOARTHRITIS

Summary/Abstract: In the context of public health, degenerative joint diseases associated with aging are among the leading causes of permanent disability and an increased need for long-term medical and social care. The growing demographic crisis in Europe and the Republic of Bulgaria, and the resulting socio-health problems of society, represent a significant scientific issue with important practical and social implications. This article presents contemporary non-operative methods for the treatment of knee osteoarthritis, including both non-pharmacological and pharmacological approaches. The combination of pathological changes leads to chronic pain, joint stiffness, and functional impairment, which significantly reduces patients’ quality of life, limits their opportunities for social integration, and affects their independence. Knee osteoarthritis is widespread among the elderly and is one of the most common musculoskeletal disorders, characterized by progressive destruction of articular cartilage, remodeling of the subchondral bone, synovial inflammation, and formation of osteophytes. The disease leads to disability worldwide, affecting over 250 million people. Its prevalence increases with age, reaching up to 10% in men and 13% in women over the age of 60. Knee osteoarthritis is the most common peripheral localization of osteoarthritis among individuals of different age groups and levels of physical activity; however, the complex mechanisms of joint damage are still not sufficiently understood. According to the World Health Organization, joint diseases significantly impair patients’ quality of life and cause substantial financial losses both for patients and for society as a whole. The aim of this article is to present and systematize contemporary non-operative methods for the treatment of knee osteoarthritis, including non-pharmacological and pharmacological approaches, and to evaluate their effectiveness based on the available scientific evidence. Materials and Methods: An analysis of scientific publications related to the non-operative treatment of knee osteoarthritis was performed. A systematic search was conducted in electronic databases such as PubMed and Google Scholar using keywords related to conservative therapeutic approaches. The analysis included review articles, randomized controlled trials, and clinical guidelines. The selection of sources included publications in English with high methodological quality and proven clinical relevance. Results and Discussion: Non-operative treatment is applicable in cases of early and moderate stages of knee osteoarthritis. The effectiveness of each therapy requires a comprehensive approach combining optimal pharmacological treatment with a structured exercise program and body weight control. Conclusion: The significant socio-health burden of the disease necessitates the development and practical implementation of a comprehensive treatment algorithm for osteoarthritis, covering the wide range of medical and social problems affecting patients. This can only be achieved through the establishment of multidisciplinary teams of professionals engaged in public health issues, health culture, and the promotion of a healthy lifestyle.

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