Daily Walking and the Risk of Knee Replacement Over 5 Years Among Adults With Advanced Knee Osteoarthritis in the United States.
Hiral Master, Louise M Thoma, Tuhina Neogi and 5 others
PMID 34175271WHAT IT FOUND
Walking more steps did not lower the risk of knee replacement over five years.
However, swapping ten minutes of slow walking for brisk walking was linked to a 35% lower risk. The study confirms walking is safe for advanced arthritis but cannot prove it prevents surgery.
Key findings
01Increasing daily step count was not associated with a lower risk of knee replacement.
02Replacing ten minutes of very-light or light walking with moderate walking was associated with a statistically significant reduction in the risk of knee replacement.
03The study was observational, so it cannot definitively conclude that walking intensity caused the lower risk of knee replacement.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was observational, so it cannot prove that brisk walking caused the lower risk of knee replacement; people who walk briskly may have had other unmeasured health factors. The five-year follow-up is shorter than the average 13 years from diagnosis to knee replacement, so long-term effects are unknown. The sample was predominantly white, overweight, and college-educated, which may limit how well the results apply to other populations. The study did not distinguish specific reasons for knee replacement, such as pain versus structural failure. Participants with mild to moderate knee pain were not the focus, as the sample had advanced structural disease regardless of pain intensity.
Declared interests
There are no competing interests for any author, and all authors have no disclosures.
The easy way to misread this
Do not interpret the 35% lower risk for brisk walking as proof that walking faster prevents knee replacement. This was an observational study, so the association could be due to confounding factors like better overall health or less severe disease in those who walk briskly, rather than the walking itself.