The recommendation has a certain level of credibility relative to the scientific evidence on the subject.
- Very high credibility
- High credibility
- Medium level of credibility
- Low credibility
General recommendations
1st recommendation: lifestyle changes, diet and physical activity. Low credibility
2nd recommendation: Intra-articular injections
3rd recommendation: Multidisciplinary approach. Low fidelity
4th recommendation: Assessment of the patient by the general practitioner or attending physician.
Non-pharmacological treatment
5th recommendation: weight loss High credibilityHigh credibility
6th recommendation: exercises with your own weight on an exercise mat. High credibility
7th recommendation: HydrotherapyHigh credibility
8th recommendation: Multimodal physiotherapy Medium level of confidence Medium level of confidence
9th recommendation: Tai Chi. Medium level of credibility
10th recommendation: Self-treatment at home after training Medium credibility
11th recommendation: thermotherapy Medium degree of credibility.
12th recommendation: electrostimulation Medium degree of credibility
13th recommendation: Acupuncture Medium level of credibility
14th recommendation: taping the patella. Low credibility
15th recommendation: massage therapy Low credibility
16th recommendation: Telephone treatment. Low credibility
17th recommendation: Magnetic telephone therapy. Low credibility
18th recommendation: laser therapy. Low credibility
19th recommendation: treatment with leeches. Low credibility
Pharmacological treatment
20th recommendation: Paracetamol with a maximum dose of 4 g/day.Very high credibility.. While not as effective as nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen has a lower rate of side effects, particularly those related to the gastrointestinal tract.
21st recommendation: Oral therapy with NSAIDsHigh credibility (NSAIDs) Short-term therapy with NSAIDs for the treatment of coxarthrosis and gonarthrosis has certain advantages. Therapy should be tailored to the age of the patient and concomitant diseases. Monitoring of blood pressure and renal function is required in elderly and disabled patients. In some cases, they should be prescribed in combination with proton pump inhibitors or COX-2 inhibitors.
22nd recommendation: Weak and strong opioids. Very high credibility
They are recommended for patients in whom arthroplasty is delayed or contraindicated. They are written as a last option.
Careful monitoring of the patient with "stepped" therapy
23rd recommendation: Intravenous injection with corticosteroids. - High credibility
24th Recommendation: Topical NSAIDs. medium. - Level of credibility
25th recommendation: Topical capsaicin. - Low credibility
26th recommendation: Oral chondroprotectors. - Medium level of credibility
27th recommendation: Glucosamine. - Medium level of credibility
No indication of therapeutic benefit
28th recommendation: orthoses, braces
29th recommendation: Electromagnetic fields
30th recommendation: Oral hyaluronic acid for arthrosis of the hip joint.
31st recommendation: chondroitin sulfate
32nd recommendation: vitamins, herbs, dietary supplements
33rd recommendation: Therapeutic ultrasound
34th recommendation: cognitive therapy.
Stefan Tserovski completed his school education at the 91st German Language High School in 2009. In 2016 he graduated from Medical University - Sofia. In 2019 he defended a dissertation on "Surgical dislocation of the hip joint in children and adolescents". He is currently a specialist in "Orthopaedics and Traumatology" at USBALO "Prof. Boycho Boychev” and assistant at the Medical University - Sofia, where he is actively engaged in teaching. He is the author of over 20 scientific papers. The www.ortoped.bg team
