Arthroscopy Association of Canada Position Statement on Exercise for Knee Osteoarthritis: A Systematic Review of Guidelines

Abstract

Background: Exercise is widely regarded to improve pain and function in patients with knee osteoarthritis (OA) through building supportive muscle mass, facilitating weight loss, and through the other beneficial effects associated with it. Purpose: To explore literature that presents clinical guidelines for the use of exercise in the treatment of knee OA to inform an evidence-based position statement for the Arthroscopy Association of Canada. Study Design: Position statement. Methods: PubMed, MEDLINE, Embase, and Cochrane databases were searched for guidelines commenting on the role of exercise for knee OA. The search was limited to guidelines published in the last 10 years. Articles were screened for relevance, focusing on recently published research with clinical guidelines. Inclusion criteria involved all articles providing clinical guidelines for exercise and knee OA. Results: Eight guidelines were identified. All eight recommended exercise as an important component of treatment for knee OA, with 6/8 strongly recommending it. Conclusion: Exercise is an effective and important component of the non-pharmacological management of knee OA. The Arthroscopy Association of Canada strongly recommends the use of exercise in the management of knee OA.

Patients that maintain their pre-injury level of physical activity 3–5 years after ACL reconstruction are, 18 months after surgery, characterised by higher levels of readiness to return to sport

“…In the present study, the included patients appeared to quit organised PA, such as football, handball, and floorball, in favour of strength training and cycling/indoor cycling, when comparing the reported type of PA from pre-injury up to 5 years after the ACL reconstruction. With respect to the recommendation that patients with knee OA should be treated with a combination of aerobic and strength training exercises that load the quadriceps and hamstring muscles at regular intervals [ 26 ], it is promising that strength training was by far the most common type of PA at all follow-ups between 18 months and 5 years after the ACL reconstruction. However, the finding that patients after an ACL reconstruction appear to give up organised sports in favour of individual exercising confirm previous findings [ 16 ], but is not unique to this group.…”

“…In patients who have developed OA, exercise therapy is strongly recommended. Therefore, to achieve the recommended levels of PA is a minimum level of PA for patients who develop OA after an ACL reconstruction [ 26 ]. Although previous studies [ 7 , 20 , 22 ] have assessed the level of PA from a long-term perspective, a few studies have investigated the frequency of PA in patients after ACL reconstruction.…”