Osteoarthritis Progression: Mitigation and Rehabilitation Strategies.
Devin Drummer, Jeremy McAdam, Regina Seay and 4 others
PMID 36188773WHAT IT FOUND
Exercise reduces pain and improves function in osteoarthritis, but no drug or biologic halts joint damage.
After knee or hip replacement, progressive resistance training reliably increases strength, though results for walking distance are inconsistent. No standardized rehabilitation protocol exists yet.
Key findings
01Exercise is strongly recommended for osteoarthritis and improves pain and function, but guidelines lack specific prescription details due to insufficient data.
02There are currently no therapeutic agents that reverse or halt osteoarthritis progression; most treatments only manage symptoms.
03Following total joint arthroplasty, progressive resistance training improves leg press and knee extension strength without increasing pain, but effects on the 6-minute walk test are inconsistent.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a narrative review, not a systematic review or meta-analysis, so it may not capture all relevant evidence or control for bias in study selection. The literature search was limited to human studies since 2015, potentially omitting earlier foundational work. The authors acknowledge that omitted topics were due to space constraints, not lack of importance. Guidelines for exercise prescription lack specificity due to insufficient data, limiting the direct applicability of recommendations for exact dosing.
Declared interests
One author (JS) has extensive financial conflicts, including consultant fees from numerous healthcare and pharmaceutical companies, ownership of stock options in biotech firms, and roles in advisory committees and speaker bureaus. The remaining authors declared no commercial or financial conflicts. Funding was provided by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
The easy way to misread this
Do not interpret this review as evidence that nutraceuticals or biologics can reverse osteoarthritis. The paper states clearly that no therapeutic agents currently halt or reverse disease progression, and many of these treatments lack large-scale, long-term randomized controlled trial data.