Comparative effectiveness of non-pharmacological interventions for knee osteoarthritis: protocol for a Bayesian...

Area of Science:

• Orthopedics and Sports Medicine
• Rheumatology
• Evidence-Based Medicine

Background:

• Knee osteoarthritis (KOA) is a leading cause of disability globally.
• Current non-pharmacological treatments for KOA lack comprehensive comparative evaluation.
• Evidence for recommended interventions remains fragmented.

Purpose of the Study:

• To systematically compare the effectiveness of first- and second-line non-pharmacological interventions for symptomatic KOA.
• To utilize Bayesian network meta-analysis (NMA) to integrate direct and indirect evidence from randomized controlled trials (RCTs).
• To provide comparative rankings of AAOS-recommended interventions.

Main Methods:

• Systematic review and Bayesian NMA of RCTs for symptomatic KOA.
• Inclusion of exercise, weight management, braces, and other guideline-recommended therapies.
• Primary outcome: pain intensity; Secondary outcomes: function, quality of life, stiffness, global assessment, adverse events.
• Comprehensive literature search, risk of bias assessment (Cochrane RoB 2.0), and GRADE certainty assessment.

Main Results:

• This section will be populated upon study completion.
• The NMA will synthesize evidence on comparative effectiveness.
• Treatment rankings will be established based on primary and secondary outcomes.

Conclusions:

• This NMA will synthesize high-quality evidence on non-pharmacological interventions for KOA.
• Findings will support individualized non-pharmacological management strategies.
• Results will inform future guideline updates and research priorities for KOA.