Hip-knee-ankle physiotherapy for the improvement of the biomechanical environment of the lower limb in knee disorders: a systematic review

Abstract

Purpose To analyse the research conducted in recent years on conservative treatment modalities for different diseases of the knee joint, to provide a correct orientation for hip-knee-ankle lower limb force line correction methods, and to provide a theoretical basis for the creation of a good mechanical environment for the knee joint, a reasonable joint space, and a neutral movement trajectory that allows for sustainable and safe treatment. Methods Information was retrieved from the electronic databases PubMed and cnki to select studies using physiotherapy as an intervention for knee related disorders between 2018–2022. Ultimately, 19 randomised controlled trial studies were included, involving a total of 1073 clinical studies. Results In the ankle area, the strength line of the lower limb can be improved by wearing custom-made insoles, gait correction training and functional and strength training of the ankle. In the knee joint, the strength and stretching of the quadriceps muscles can be strengthened and the line of force of the lower limb stabilised through different training modalities (centripetal and centrifugal training, electrical nerve stimulation, blood flow restriction training). At the hip joint the control of the lower limb can be increased by increasing the strength of the hip joint in external rotation and abduction and by improving the pain at the joint using acupuncture therapy and physiotherapy with tui na. Conclusions By physically adjusting the hip-knee-ankle joint, it is possible to treat knee-related disorders by progressively correcting the aberrant lower limb force lines and improving the knee-related disorders' symptoms.