Declaração de consenso da Sociedade Italiana de Ortopedia e Traumatologia sobre o tratamento não cirúrgico da osteoartrite do joelho
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Osteoartrite, Osteoartrite De Joelho, Posicionamento Da SIOT, Manejo Não Cirúrgico, Hidroterapia, atividade aquáticaResumo
A osteoartrite (OA) do joelho é uma doença crônica associada a um impacto significativo na qualidade de vida. No entanto, infelizmente, não existem diretrizes baseadas em evidências para o tratamento não cirúrgico dessa doença. Reconhecendo a lacuna entre as evidências científicas e a prática clínica, este posicionamento visa apresentar recomendações para o tratamento não cirúrgico da OA do joelho, considerando as evidências disponíveis e o conhecimento clínico de cirurgiões experientes. O objetivo geral é oferecer uma opinião de especialistas fundamentada em evidências, auxiliando os profissionais de saúde no manejo da OA do joelho e levando em conta a condição, os valores, as necessidades e as preferências de cada paciente.
Foram elaboradas recomendações baseadas em evidências para o tratamento não cirúrgico da OA de joelho, abrangendo avaliação, abordagem geral, informação e educação do paciente, mudanças no estilo de vida e fisioterapia, dispositivos de auxílio à marcha, balneoterapia, estimulação elétrica nervosa transcutânea, terapia por campo eletromagnético pulsado, intervenções farmacológicas e infiltrações.
Para o tratamento não cirúrgico da OA de joelho, a primeira medida recomendada é a implementação de mudanças no estilo de vida, particularmente o controle do peso corporal combinado com exercícios físicos e/ou hidroterapia. Para sintomas agudos, podem ser utilizados anti-inflamatórios não esteroides (AINEs), por via tópica ou oral. O uso de opioides é reservado apenas para a terceira linha de tratamento farmacológico. A glucosamina e a condroitina também são sugeridas como tratamento farmacológico de longo prazo. Quanto à terapia infiltrativa intra-articular, recomenda-se o uso de ácido hialurônico em casos de OA de joelho crônica (plasma rico em plaquetas (PRP) como segunda linha), na ausência de doença aguda ativa, ao passo que o uso de injeções intra-articulares de cortisona é eficaz e preferível para sintomas agudos graves.
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Artigo adaptado e traduzido para o português pelos editores de NADAR! SWIMMING MAGAZINE para republicação, conforme normas de submissão do periódico. Versão original em: https://pmc.ncbi.nlm.nih.gov/articles/PMC10485223/
Image for illustrative purposes only: https://www.magnific.com/author/brgfx
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Copyright (c) 2026 Elisa Pesare Pesare, Giovanni Vicenti, Elisaveta Kon, Massimo Berruto, Roberto Caporali , Biagio Moretti, Pietro S Randelli
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