How Effective is Physical Therapy in Treating Patients with Knee Osteoarthritis?

Knee osteoarthritis affects millions of Americans and is a significant medical concern. Of those seeking ambulatory healthcare, close to 50% of individuals over the age of 60 did so for knee osteoarthritis (OA). Knee OA is a degenerative joint disease characterized by diffuse knee joint pain, stiffness, decreased strength and increased difficulty with daily activities.  

Anterior Knee Pain A Holistic Approach to Treatment
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Physical therapists are highly qualified to evaluate and treat patients suffering from this debilitating disease. Physical therapists are known to be disease modifiers through the use of various interventions like manual therapy and medical exercise training. These interventions aim to provide pain relief, improve joint range of motion, and improve muscle strength and aerobic fitness.  Since knee pain, weakness, and loss of joint motion are common in knee OA, improving your range of motion and muscle strength of sufficient dosage has the ability to reduce joint pain and improve physical function. (2)

In a study published in the New England Journal of Medicine by Kirkley et al. in 2008, arthroscopic debridement in addition to physical and medical therapy was compared to physical and medical therapy alone for the treatment of patients with moderate to severe knee OA. What they found was that arthroscopic surgery plus physical and medical therapy provided no additional benefit, in terms of functional outcome compared to physical and medical therapy alone.  To further hone in on the effectiveness of physical therapy in treating patients with knee OA, Fransen et al. recently published a systematic review with over 5,000 participants that looked at the benefit of land-based exercise for the reduction of joint pain or improved physical function and quality of life in patients with knee OA.

What Does This Study Mean for Patients with Knee OA?

How Patients with Knee OA Benefit from Physical Therapy

However, even though both groups improved, subjects treated in the clinical group achieved twice as much functional improvement compared to those who performed unsupervised home exercises. This group was also less likely to be taking pain relief medications for their arthritis and was more satisfied with the overall outcome of their rehabilitative treatment after one year.  So one can see that these results suggest people with knee OA need some form of ongoing monitoring or supervision to optimize clinical benefits of exercise treatment (1). Physical therapy can be extremely helpful in managing knee OA.  The key is to keep your knee moving—“motion is lotion.”  Below are some beginner exercises that you can do to help get

your knee stronger.

1. Deyle, G., Allison, S., & Matekel, R. (2005). Physical Therapy Treatment Effectiveness for Osteoarthritis of the Knee: A randomized Comparison of Supervised clinical Exercise and Manual Therapy Procedures Versus a Home Exercise Program. Physical Therapy, 85(12), 1301-1315.

2. Fransen, M., & Mcconnell, S. (2015). Exercise for osteoarthritis of the knee. Cochrane Database of Systematic Reviews Reviews, 1-6.

3. Juhl, C., Christensen, R., Roos, E., Zhang, W., & Lund, H. (2014). Impact of Exercise Type and Dose on Pain and Disability in Knee Osteoarthritis: A Systematic Review and Meta-Regression Analysis of Randomized Controlled Trials. Arthritis & Rheumatology, 66(3), 622-636.

4. Kirkley, A., & Birmingham, T.,(2008). A Randomized Trial of Arthroscopic Surgery for Osteoarthritis of the Knee. New England Journal of Medicine, 359(11), 1097-1106.

5. Bhatia D, Bejarano T, Novo M. Current interventions in the management of knee osteoarthritis. Journal of Pharmacy & BioAllied Sciences 2013 Jan-Mar; 5(1): 30-38

RON MASRI, PT, DPT, OCS, ATC, FAAOMPT
rmasri@totalmotionpt.net