Résumé
Background: knee osteoarthritis is a common osteoarticular disease responsible for considerable healthcare expenditure. Management is based on a combination of pharmacological and non-pharmacological treatment. Following the recommendations of the French Society of Rheumatology of December 2020 on the pharmacological management of knee osteoarthritis, a working group was organised to make recommendations on non-pharmacological management. Objective: to understand the perceived experience of those involved in the management of knee osteoarthritis with regard to 3 non-drug interventions (physical activity, therapeutic education and self-management, weight control measures). Methods: systematic review of the literature from 4 bibliographic databases: PubMed Central / Medline, Cochrane Library, Pascal and Francis database, public health database. Double evaluation of the methodological quality of the included studies with the CASP (Critical Appraisal Skills Programme) grid. Production of a thematic summary of the main results of the articles included. Results: 57 articles were included in the final analysis (50 qualitative studies, 5 mixed studies and 2 literature reviews) reporting the views of 950 adult patients with knee osteoarthritis, 35 primary caregivers and 314 caregivers caring for patients with knee osteoarthritis. This review highlights representations that may be obstacles to care (such as the fatalistic view of the mechanisms of knee osteoarthritis) but also representations that favour it. It explores the perception of the role and skills of each person in the care pathway, emphasising the importance of teamwork, comprehensive patient care, the caregiver-patient relationship and peer support. Conclusion: we have explored the point of view of those involved in the management of gonarthrosis with regard to non-pharmacological management, which has enabled us to understand the patient's point of view. It is important to fight against fatalistic representations and misconceptions, to listen to the patient in order to try to understand him or her and ultimately to find out what motivates him or her to improve his or her quality of life. Future studies should be based on quality of life criteria to improve the overall care of the patient.