Knee Osteoarthritis

Treatments

Exercises such as resistance training, body weight strengthening, tai- chi and pilates have been found most effective for pain management as well as improving the strength and control in the muscles surrounding the joint [1][2].
Hydrotherapy in a heated pool has been proven to provide short term benefits as it reduces the load going through the joint and can allow for gentle stretching, strengthening and aerobic training in a safe environment. Research has found a significant decrease in pain and increase in function of the knee when hydrotherapy is undertaken twice a week [1][3][4].
There is a growing amount of evidence supporting the use of massage therapy for reducing pain, stiffness and improving function of the knee [5][6].
Similarly, acupuncture can be effective at reducing pain and stiffness in the joint [1][7].
If therapy has not been effective at managing the condition and the knee pain is affecting the quality of life then a knee replacement may be considered. Post surgical physiotherapy is incredibly important to get the new joint moving properly and strengthen the surrounding muscles. [8]
Balanced offer a non-surgical alternative called APOS Therapy which is a clinically proven calibrated shoe that redirects the forces going through the joint to the non-damaged portion while retraining the bodys neuromuscular system to adopt an optimal walking pattern that reduces pain and improves function of the knee[9][10].
Knee offloading bracing has been shown to reduce pain and allow for an increased activity level in people with unicompartmental knee Osteoarthritis [11]. Unloading knee braces work by applying a three point force system to the knee to move pressure away from the damaged side of the knee to the undamaged side. They are often used to delay surgery when a knee replacement is required [12]

References

1.https://www.sciencedirect.com/science/article/pii/S1063458414000168 T.E. McAlindon et al., OARSI guidelines for the non-surgical management of knee osteoarthritis, Osteoarthritis Research Society International, 2014, 22: 363-388
2. https://www.sciencedirect.com/science/article/pii/S1744388117301871 Mazloum, V., Rabiei, P., Rahnama, N. and Sabzehparvar, E., 2018. The comparison of the effectiveness of conventional therapeutic exercises and Pilates on pain and function in patients with knee osteoarthritis. Complementary therapies in clinical practice, 31, pp.343-348.
3. https://www.sciencedirect.com/science/article/abs/pii/S1413355517302514 Dias, J.M., Cisneros, L., Dias, R., Fritsch, C., Gomes, W., Pereira, L., Santos, M.L. and Ferreira, P.H., 2017. Hydrotherapy improves pain and function in older women with knee osteoarthritis: a randomized controlled trial. Brazilian journal of physical therapy, 21(6), pp.449-456.
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6676973/ Sekome, K. and Maddocks, S., 2019. The short-term effects of hydrotherapy on pain and self-perceived functional status in individuals living with osteoarthritis of the knee joint. The South African Journal of Physiotherapy, 75(1).
5. https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/769544 A.I. Perlman et al., Massage Therapy for Osteoarthritis of the Knee, Archives of Internal Medicine, 2006, 166: 2533-2538
6. https://link.springer.com/article/10.1007/s11606-018-4763-5 Perlman, A., Fogerite, S.G., Glass, O., Bechard, E., Ali, A., Njike, V.Y., Pieper, C., Dmitrieva, N.O., Luciano, A., Rosenberger, L. and Keever, T., 2019. Efficacy and Safety of Massage for Osteoarthritis of the Knee: a Randomized Clinical Trial. Journal of general internal medicine, 34(3), pp.379-386.
7. https://journals.sagepub.com/doi/abs/10.1136/aim.22.1.14 Tukmachi, E., Jubb, R., Dempsey, E. and Jones, P., 2004. The effect of acupuncture on the symptoms of knee osteoarthritis-an open randomised controlled study. Acupuncture in Medicine, 22(1), pp.14-22.
8. https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-015-0469-6 Artz, N., Elvers, K.T., Lowe, C.M., Sackley, C., Jepson, P. and Beswick, A.D., 2015. Effectiveness of physiotherapy exercise following total knee replacement: systematic review and meta-analysis. BMC musculoskeletal disorders, 16(1), p.15.
9. https://www.apostherapy.co.uk/conditions-we-treat/knee-pain/knee-osteoarthritis/
10. https://www.hindawi.com/journals/arthritis/2013/689236/abs/ Bar-Ziv, Y., Debbi, E.M., Ran, Y., Benedict, S., Halperin, N. and Beer, Y., 2013. Long-term effects of AposTherapy in patients with osteoarthritis of the knee: a two-year followup. Arthritis, 2013.
11 P. Y. F. Lee, T. G. Winfield, S. R. S. Harris, E. Storey, and A. Chandratreya, “Unloading knee brace is a cost-effective method to bridge and delay surgery in unicompartmental knee arthritis,” BMJ Open Sport Exerc. Med., vol. 2, no. 1, pp. 1–8, 2017, doi: 10.1136/bmjsem-2016-000195.
12 H. F. Hjartarson and S. Toksvig-Larsen, “The clinical effect of unloader one® knee brace on patients with osteoarthritis of the knee. A randomized placebo controlled trial,” BMC Musculoskelet. Disord., vol. 19, p. 341, 2018, doi: 10.1016/j.joca.2017.02.299.