ASSESSMENT OF PHYSIOTHERAPISTS’ KNOWLEDGE AND ADHERENCE TO CLINICAL PRACTICE GUIDELINES (CPGs) OF KNEE OSTEOARTHRITIS: A CROSS-SECTIONAL STUDY

Background: Osteoarthritis (OA) is one of the most prevalent musculoskeletal disorders and a leading cause of pain and disability worldwide, particularly affecting weight-bearing joints such as the hip and knee. Physical therapy plays a crucial role in the conservative management of knee osteoarthritis (KOA). However, inadequate knowledge and poor adherence to evidence-based Clinical Practice Guidelines (CPGs) may contribute to suboptimal patient outcomes. Physiotherapists are expected not only to understand current guideline recommendations but also to implement them effectively in clinical practice. Objective: To assess physiotherapists’ knowledge of and adherence to Clinical Practice Guidelines (CPGs) for the management of knee osteoarthritis. Methodology: A cross-sectional online survey was conducted among physiotherapists working in Khyber Pakhtunkhwa. Participants were recruited using a non-probability convenience sampling technique, and informed consent was obtained prior to participation. Demographic data including age, gender, level of education, and years of clinical experience were collected. Knowledge of knee OA CPGs was assessed through agreement with 23 guideline-based statements using a Likert scale, with consensus defined as ≥70% agreement. Adherence was evaluated using a clinical vignette describing a case of knee osteoarthritis, where responses were categorized as Delivering, Partially Delivering, or Non-Delivering recommended treatment. Results; A total of 289 physiotherapists participated in the study. The mean age was 26.99 ± 2.90 years. Among them, 90 (31.1%) were male and 199 (68.9%) were female. Consensus was achieved for 13 out of 23 statements related to knee OA CPGs. Level of education showed a statistically significant association with adherence (p = 0.03). The overall adherence was low, with 4 (1.4%) physiotherapists categorized as Delivering, 108 (37.4%) as Partially Delivering, and 177 (61.2%) as Non-Delivering recommended treatment. Conclusion: The findings indicate that physiotherapists demonstrated a good level of knowledge regarding knee OA CPGs, particularly concerning weight loss advice and patient education on pathophysiology. However, adherence to guideline-recommended interventions in clinical practice was low. Level of education significantly influenced adherence. The study highlights a considerable evidence–practice gap and emphasizes the need for structured implementation strategies to improve adherence to CPGs.