Physical Therapy, Exercise Program Helps Knee Arthritis

Physical therapy combined with a supervised exercise program can improve symptoms of osteoarthritis of the knee and perhaps reduce the need for surgery, according to a team of army doctors.

“Patients with osteoarthritis of the knee should have a trial of physical therapy before more complicated or risk-prone alternatives, such as surgery or medical regimes, are attempted,” lead study author Col. Gail D. Deyle of the Brooke Army Medical Center in Fort Sam Houston, Texas, told Reuters Health.

Deyle and colleagues studied 83 patients with osteoarthritis of the knee who were randomly assigned to one of two groups. Patients in the first group underwent manual physical therapy, which was applied to the knees, ankles and spine, together with knee exercises done in the clinic and at home. Patients in the second group were given a placebo treatment, in which they underwent ultrasound at subtherapeutic levels.

Patients in both groups were treated twice a week for 4 weeks, and neither group knew what treatment patients in the other group were receiving. The researchers used a standard test to calculate the knee stiffness, pain, and dysfunction in both groups over the course of one year.

Writing in the February 1st issue of the Annals of Internal Medicine, the authors report that patients in the treatment group had “clinically and statistically significant” improvements in symptoms.

The study also showed that 20% of patients in the placebo group needed knee arthroscopy, a surgical procedure where surgeons use an instrument to examine inside the knee. In contrast, only 5% of those in the treatment group required the procedure.

“A combination of manual physical therapy and supervised exercise yields functional benefits for patients with osteoarthritis of the knee,” the researchers conclude.

In the interview, Deyle advised doctors caring for patients with osteoarthritis of the knee to refer them to a physical therapist with orthopedic experience, saying that this “would be in the patient’s best interest.”

SOURCE: Annals of Internal Medicine 2000;132:173-181.