Knee osteoarthritis is a chronic condition affecting the knee joint and the most common form of chronic arthritis. Common symptoms include joint pain, stiffness and swelling. Osteoarthritis most frequently occurs in people aged >55 years, with risk factors including previous joint injury, being overweight or obese, and older age. It is expected that the rate of Australians with osteoarthritis is expected to rise from 2.2 million in 2015 to almost 3.1 million by 2030.
There is currently no cure for knee osteoarthritis, but there are many non-surgical treatments and approaches to managing the long-term symptoms of this disease. In 2018 the RACGP released an updated version of the Guideline for the management of knee and hip osteoarthritis with advice and recommendations for the management of people with knee and/or hip osteoarthritis. The guideline has a strong focus on self-management and non-surgical treatments to improve the health of people with knee and/or hip osteoarthritis.
Frequently Asked Questions
Why do people with increased body weight have a higher incidence of osteoarthritis?
Osteoarthritis is the leading cause of pain and disability worldwide and is associated with increased all-cause mortality and cardiovascular disease. Osteoarthritis is strongly associated with obesity, suggesting that either increased biomechanical joint loading or systemic inflammation and metabolic dysfunction related to obesity are responsible for joint degeneration.However, increasing evidence is mounting that changes in biomechanical loading due to increased body mass do not account for the severity of obesity-induced knee osteoarthritis. These observations suggest that other factors related to the presence of adipose tissue and adipose tissue-derived cytokines—termed adipokines—play critical roles in this process and other musculoskeletal conditions
What are the strongly recommended interventions for managing knee osteoarthritis?
The Royal Australian College of General Practitioners (RACGP) has produced guidelines for the management of knee osteoarthritis, providing strong evidence for the following interventions:
- Land-based exercise aimed at the knee is strongly recommended for people with knee osteoarthritis. Exercise has been shown to improve knee pain and function, and disease severity. Land-based exercise may be walking and/or strength-based exercises.
Weight management in combination with land-based exercise can aid in producing greater benefits and improvements in those with knee osteoarthritis. For those with a BMI of 25kg/m2 or over, aiming for a loss of 5-7.5% body weight is recommended.
What are the moderately recommended interventions for managing knee osteoarthritis?
The Royal Australian College of General Practitioners (RACGP) has produced guidelines for the management of knee osteoarthritis, providing moderate evidence for the following interventions:
- Cognitive behavioural therapy (CBT) may benefit an individual with knee osteoarthritis when considering psychological comorbidities including depression and anxiety.
- Stationary cycling and hatha yoga may be beneficial to those who are finding more strenuous land-based activities difficult. Both cycling and yoga can be considered gentler exercise, though walking and strength-based exercises have been shown to provide greater benefits.
- Aquatic exercise or hydrotherapy can improve knee function. Although the water is a resistance and the knee joint can be loaded in an aquatic setting, it should be noted that there is less load on the knee joint in this environment and therefore, not as beneficial as land-based exercise.
- Massage therapy can be considered as a short course treatment and only has an adjunctive therapy to active interventions.
- Manual therapy including stretching, soft tissue mobilisation, joint mobilisation and joint manipulation can be utilised but only in conjunction with active interventions.