S3-Leitlinie Gonarthrose: evidenzbasiertes Update und Paradigmenwechsel hin zur aktiven Therapie
摘要
The new S3 guideline on the prevention and treatment of knee osteoarthritis represents a methodological and conceptual advance over the previous S2k guideline by combining systematic evidence synthesis with structured consensus processes. This review summarizes its key recommendations and clinically relevant innovations. Exercise therapy and patient education are defined as the foundation of treatment, emphasizing adherence and a realistic understanding of pain („hurt ≠ harm“). Many passive physical modalities are no longer recommended because of insufficient evidence. Pharmacological and intra-articular treatments should be used cautiously and selectively. Arthroscopic procedures are not recommended, whereas knee arthroplasty should be considered in the context of individual risk factors and realistic patient expectations. The guideline also highlights sustainability and shared decision-making.