Knee Osteoarthritis

About Knee Osteoarthritis

Did you know that knee osteoarthritis (OA) is the leading cause of disability in adults, with healthcare costs to treat the condition rising to $13.2 billion dollars per year (1)? The most common type of osteoarthritis, knee OA, causes mild to moderate disability among >10% of adults who are age 55 or older (2). According to medical research, up to 70% of older adults have noticeable OA changes when the area is imaged, but they remain asymptomatic (3). Clinical examinations of the knee area, as shown in the following findings (4), have been proven to assist in ruling out (with a sensitivity of .91) and ruling in (specificity of .86) knee OA.

How is it treated?

Effective management of knee OA includes modifying your current activities, following sensible weight-loss and exercise plan and utilizing manual therapy that includes joint mobilization, manipulation and soft tissue treatments (7,8). Grade A Oxford Level of Evidence was found with a combined exercise and manual therapy approach to knee OA (9). All clinical guidelines for effective management of knee OA recommend exercise in treatment (5,6).

What the evidence says

In Deyle et al, there were improvements in pain, disability and function that were demonstrated after patients had undergone physical therapy treatments that included exercise interventions and manual therapy treatments. In some patients, there was a 20-40% improvement after just 2-3 visits. For some cases, the treatment program made it possible to completely avoid or delay a total knee replacement (9).

Researchers have found that manual therapy is more cost effective and clinically effective when compared with typical medical treatments for knee OA, with improvements noted for up to 1 year after therapy (11,12). Manual therapy that is combined with exercise has also shown to be twice as successful as short-term programs designed for in-home treatment to improve function and reduce pain (13). The Cochrane Review also supports using exercise to reduce the painful symptoms of knee OA, in addition to improving overall strength and physical fitness (10).

Are you suffering from knee OA?

The majority of patients with knee pain and symptoms of OA will benefit from a program that includes manual therapy and exercise. If you have knee pain/stiffness, pain when using stairs or when in motion, see what Total Motion Physical Therapy can do for you.

References

1. Leigh, J. et al. estimating the costs of job related arthritis. J Theumetol. 2001. (28(7): 1647-54.
2. Peat G. et al. Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care. Ann Rheum Dis. 2001. 60(2): 91-7
3. Guermazi, A. et al. Prevalence of abnormalities in knees detected by MRI in adults without knee osteoarthritis: population based observational study. BMJ. 2012.
4. Altman, R. et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of OA of the knee. Arthritis Thuem. 1986. 29(8): 1039-49.
5. Fernades L, Hagen KB, Bislsma JW, Andreessen O, Christensen P, Conagham PG, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann Rhuem Dis 2013;72:1125-35
6. Zhang W, Moskowitz RW, Nuke G, Abramson S, Altman RD, Arden N, et al. OARSI recommendations for the management of hip and knee osteoarthritis. Part II: OARSI evidenced-based, expert consensus guidelines. Osteoarthritis Cartilage 2008;16: 137-62.
7. Larmer, P. et al. Systematic Review of Guidelines for the Physical Management of Osteoarthritis. Arch Phys Med Rehab 2014. 95:375-389
8. Jamtvedt, G. et al. PT interventions for patients with osteoarthritis o the knee: An overview of systematic review. PT. 2008. 88(1).
9. Deyle, G et al. Effectiveness of manual physical therapy and exercise in osteoarthritis of the knee. A RCT. Ann Int Med. 2000. 132(3):173-81
10. MConnell, F. et al. Exercise for osteoarthritis of the knee. Cochrane Review. 2015.
11. Abbot, J. Manual therapy, exercise therapy, or both, in addition to usual care, for osteoarthritis of the hip or knee: Economic evaluation alongside a RCT. Osteoarthritis and cartilage. 2013. 21:1504-1513.
12. Pinto, D. Manual therapy, exercise therapy, or both in addition to usual care, for PA of the hip or knee. Economic evaluation alongside a RCT. Osteoarthritis and Cartilage. 2013 21:1504-1513.
13. Deyle, G. et al. Physical therapy treatment effectiveness for osteoarthritis of the knee: a randomized comparison of supervised clinical exercise and manual therapy procedure versus a home exercise program. Phys Ther. 2005;85:1301-1317.