Knee osteoarthritis affects approximately 1/3.of all individuals, with an increasing prevalence as the population ages. The medial compartment of the knee is often most affected due to it's weightbearing structure where the cartilage, surrounding bone, soft tissue, ligaments, synovial fluid and muscles are subject to physiological and biological changes.
Compression and loading of the knee joint are reversible factors that contribute to the progression of osteoarthritis. Insufficient strength through the hip abductors and Quadriceps muscles are contributing factors to the onset of wear and tear in the knee, and strengthening these areas helps protect the knee joint cartilage by absorbing the loads placed on the joint.
According to the evidence, hip abductor strengthening effectively relieves knee discomfort by lowering pain scores, improving self-reported functional outcomes, enhancing physical performance and providing an overall sense of well-being. Hip abductors are important for supporting and stabilising the trunk and assisting limb placement control during functional tasks, such as walking. Exercise programmes designed for a duration of 3-5 times per week, over a period of 6-9 weeks yield the best outcomes. Resistance should be centred between 50-80% of one-rep max, at an intensity of 8-20 repetitions for 2-3 sets.
Conservative management in knee osteoarthritis mainly revolves around reducing the mechanical load on the joint. Osteoarthritis has a strong genetic disposition but environmental factors also influence its prevalence such as obesity, age, injury, repeated joint stress, and certain metabolic diseases. Addressing these environmental factors will effectively slow the progression of osteoarthritic changes allowing a more positive quality of life.
Thomas, D.T. et al (2022). Hip abductor strengthening in patients diagnosed with knee osteoarthritis - a systematic review and meta-analysis. BMC Musculoskeletal Disorders. 23: 622. .
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