Modern Approaches to Early Diagnosis of Knee Osteoarthritis and Optimization of Treatment Tactics
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Knee osteoarthritis is a leading cause of pain, disability, and reduced quality of life worldwide, and its burden is rising with population aging and obesity. Most patients are diagnosed at advanced stages, when structural damage is largely irreversible. Conventional radiography detects KOA only after considerable cartilage loss, and there is no consensus on a standardized algorithm for identifying early disease or on treatment strategies tailored to disease stage and patient phenotype. This review analyzed recent clinical guidelines and peer-reviewed studies on clinical assessment, imaging radiography, ultrasonography, and biochemical markers of cartilage and bone turnover, together with pharmacological, non-pharmacological, and surgical treatment approaches. Early KOA can be identified through combined clinical evaluation and sensitive imaging; MRI and ultrasonography reveal cartilage, synovial, and meniscal changes before radiographic signs appear, while biomarkers show promise as adjuncts. Core treatment includes patient education, structured exercise, and weight management, supplemented by topical or oral analgesics and intra-articular therapies. Arthroplasty is reserved for advanced disease. A stage-based, individualized strategy that integrates early multimodal diagnosis with timely conservative treatment may slow progression, reduce pain, and delay surgery. Prospective trials are needed to validate diagnostic algorithms and compare treatment effectiveness.
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