Knee osteoarthritis is not simply "wear and tear" that must be endured. Load, muscle strength and body weight all change how quickly the joint deteriorates, and all three can be influenced.
Strength first
The quadriceps act as the knee's shock absorber. Progressive strengthening reliably reduces pain and improves walking distance, often more than any passive treatment.
Weight and load
Each kilogram lost removes several kilograms of force from the knee with every step. Combined with activity modification, this is the highest-value change most patients can make.
Intra-articular therapy
Where pain limits exercise, viscosupplementation or a guided steroid injection can restore enough comfort to make a strengthening programme possible.
