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World J Orthop. Apr 18, 2026; 17(4): 114991
Published online Apr 18, 2026. doi: 10.5312/wjo.v17.i4.114991
Published online Apr 18, 2026. doi: 10.5312/wjo.v17.i4.114991
Treatment options for patients with advanced osteoarthritis who decline knee surgery
Jakub Kacprzak, Robert Kołaczyński, Adam Surma, Dominik Sokalski, Jakub Piotr Adamus, Student Scientific Association of Reconstructive and Oncology Orthopedics, Medical Uni
Łukasz Pulik, Paweł Łęgosz, Department of Orthopedics and Traumatology, Medical University of Warsaw, Warsaw 02-005, Mazowieckie, Poland
Co-corresponding authors: Jakub Kacprzak and Łukasz Pulik.
Author contributions: Kacprzak J, Kołaczyński R, Surma A, Sokalski D, and Adamus JP performed literature analysis and wrote the manuscript; Kacprzak J and Surma A prepared tables; Kacprzak J prepared figure; Pulik Ł provided the research concept and supervised the literature analysis; Pulik Ł and Łęgosz P reviewed the manuscript; Kacprzak J and Pulik Ł have played important and indispensable roles in the manuscript preparation as the co-corresponding authors.
Conflict-of-interest statement: The authors declare no conflict of interest.
Corresponding author: Jakub Kacprzak, Student Scientific Association of Reconstructive and Oncology Orthopedics, Medical University of Warsaw, 61 Żwirki i Wigury St, Warsaw 02-091, Mazowieckie, Poland. k.jakub.kacprzak@gmail.com
Received: October 10, 2025
Revised: October 24, 2025
Accepted: January 14, 2026
Published online: April 18, 2026
Processing time: 188 Days and 11.4 Hours
Revised: October 24, 2025
Accepted: January 14, 2026
Published online: April 18, 2026
Processing time: 188 Days and 11.4 Hours
Core Tip
Core Tip: Among the reviewed guidelines, there is agreement on first-line therapies, specifically weight loss, exercise, and topical non-steroidal anti-inflammatory drugs (NSAIDs). Secondary treatment options, such as oral NSAIDs, intra-articular corticosteroids, and acetaminophen, are recommended but with varying support. Beyond these therapies, the guidelines provide substantially varied recommendations. Emerging therapies that are not covered by current guidelines, such as minimally invasive interventions and novel pharmacological agents, offer promising alternative strategies.