Knee osteoarthritis – also known as degenerative knee arthritis – is a common chronic joint disease. Patients typically experience pain, limited mobility, and a reduced quality of life. Foreign research indicates that among over 3,000 participants, about 45 percent have the chance of developing symptomatic knee osteoarthritis in their lifetime.
Osteoarthritis can involve all joint tissues, including cartilage, bone, the joint capsule, ligaments, and muscles. In addition to the wear and tear of articular cartilage, bone spurs (commonly known as "osteophytes") can also develop.
Knee osteoarthritis is caused by a combination of factors. Age is one of the primary risk factors, while obesity and being overweight are also well-established risks. Knee injuries and occupation, particularly jobs requiring heavy lifting, kneeling, or squatting, are also key factors. Furthermore, a 2023 study found that sarcopenia (age-related muscle loss) could also potentially lead to osteoarthritis.
The management of knee osteoarthritis not only focuses on treating pain and functional impairment caused by the pathology but also on how to delay or prevent structural deterioration. Patient education, targeted exercise, and appropriate weight control are all core to treatment.
Exercise therapy is considered a beneficial approach for treating at least 26 chronic diseases, while also improving sleep, enhancing cognitive function, and boosting mood. Currently, there is no data indicating which specific type or combination of exercises is most suitable for knee osteoarthritis patients. However, quadriceps strength training has been proven effective in reducing knee osteoarthritis pain and can be prioritized in personalized treatment plans. The following types of exercise have all been shown to be beneficial:
However, maintaining patient adherence to exercise is a major challenge. A 2013 study showed that 87 percent of knee osteoarthritis patients failed to meet physical activity guideline recommendations. A 2023 systematic review assessing exercise adherence in knee osteoarthritis clinical trials found the average patient adherence rate to exercise was only 67.9 percent.
A study done in Australia in 2022 pointed out that reasons preventing osteoarthritis patients from receiving first-line treatments include cost, waiting times, lack of services in the community, and patient misconceptions. These misconceptions include wrongly believing that surgery is the only effective treatment, or fearing that exercise will exacerbate pain and worsen the condition. In fact, multiple studies consistently show that appropriate and moderate exercise does not negatively affect knee articular cartilage.
Knee osteoarthritis is not an inevitable condition of aging, and exercise is an indispensable part of the treatment for all patients. Active participation in self-management programs, regular physical activity, and personalized exercise plans (including muscle strengthening, aerobic exercise, and flexibility training) can alleviate pain, prevent the condition from worsening, and enhance daily function. Additionally, manual therapy, acupuncture, knee braces and taping, and walking aids are all other options that knee osteoarthritis patients can try.
The above content is compiled from recent related studies and books. If you have any questions, please consult a doctor or physiotherapist for advice to develop the most suitable self-management strategy.
Authored by: Chan Siu On, Senior Lecturer, School of Nursing and Health Studies, Hong Kong Metropolitan University, Registered Physiotherapist.
