OsteoArthritis of the Knee

An Evidence-Based Approach for Patients with Osteoarthritis of the Knee

OsteoArthritis Symptoms:

  • Symptoms of pain with walking, transfers, squatting, lifting and during recreational activities may be signs of osteoarthritis of the knee.  Altman (1991) clinically defined knee osteoarthritis as a patient presentation of knee pain, morning joint stiffness greater than 30 minutes, and crepitus with active motion.

Proven Solutions for OsteoArthritis of the Knee

  • Rehabilitative Exercise
  •  Manual Therapy
  • IMS (Intramuscular Stimulation) or TDN
  • Evidence Based Care


  • Individuals who completed 4 weeks (8 visits) of manual physical therapy used less arthritis medication up to one year later than those that did not receive manual techniques as part of their physical therapy program.  Many patients reported up to 20-40% improvement after only 2-3 treatments.
  • Significant decrease in pain and increase in ROM with following hip mobilization for patients with knee OA.
  • Therapeutic Exercise and Manual Therapy are recommended treatments for patients with OA because of strong evidence (grades A, B and C+) shown during the Ottawa Methods Group’s review on evidence-based clinical practice guidelines for physical therapy interventions in OA and RA.
  • Manual Therapy appeared to be superior to exercise therapy for hip function, ROM and pain.
  • Evidence supports the effectiveness and safety of moderate to high intensity aerobic and strengthening exercises for osteoarthritis and stable rheumatoid arthritis.
1. Altman RD. Criteria for classification of clinical osteoarthritis . J Rheumatol Suppl. 1991; 27:10-12.
2. Cliborne AV, Wainner RS, Rhon DI, Judd DS, Fee TT, Maetkel RL, Whitman JM. Clinical hip tests and a functional squat test in patients with knee osteoarthritis: reliability, prevalence of positive test findings, and short term response to hip mobilization. JOSPT. 2004; 34(11)676-687.
3. Corti MC, Rigon C. Epidemiology of osteoarthritis: prevalence, risk factors, and functional impact. Aging Clin Exp Res. 2003;15:359-363.
4. Deyle GD, Allison SC, Matekel RL, et al. 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. Phys Ther. 2005; Dec;85(12):1301-17.
5. Deyle GD, Henderson NE, Matekel RL, et all. Effectiveness of Manual Physical Therapy and Exercise in Osteoarthritis of the knee: A Randomized, Controlled Trial. Annals of Internal Medicine. 2000;132(3):173-181.
6. Ottawa panel evidence-based clinical practice guidelines for therapeutic exercises and manual therapy in the management of osteoarthritis. Phys Ther. 2005 Sep;85(9): 907-71.
7.Hoeksma HL, Dekker J, Breedveld FC, et al.  A comparison of manual therapy and exercise therapy in osteoarthritis of the hip:  results of a randomized clinical trial.  Arthritis Rheum (in press).
8. Westby M, Li L.  Geriatrics Aging.  2006;9(9):624-630.


I tore my groin very bad playing hockey. I did a lot of research and chose Dr. Anne-Marie Fox for some IMS therapy. I went for 3 applications and the healing ...

- Carter Einhorn
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