Cochrane for Clinicians

Putting Evidence into Practice

Exercise for Osteoarthritis of the Knee


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Am Fam Physician. 2015 Nov 1;92(9):774-775.

Author disclosure: No relevant financial affiliations.

Clinical Question

Does land-based exercise reduce joint pain or improve physical function and quality of life in patients with knee osteoarthritis?

Evidence-Based Answer

Land-based exercise programs reduce knee pain and improve quality of life and physical function following treatment in patients with knee osteoarthritis. (Strength of Recommendation: A, based on consistent, good-quality patient-oriented evidence.)

Practice Pointers

Osteoarthritis of the knee is a degenerative disease of the joint involving the articular cartilage and underlying bone. Osteoarthritis is the most common form of arthritis, affecting nearly 27 million persons in the United States.1 As the population ages and the prevalence of obesity increases, the prevalence of knee osteoarthritis and its impact on pain and physical function are expected to increase as well.1 Although no cure exists, exercise is a nonpharmacologic therapy commonly recommended for patients with osteoarthritis.2,3

This updated systematic review includes 54 studies of patients with mild to moderate symptomatic knee osteoar

Author disclosure: No relevant financial affiliations.

The practice recommendations in this activity are available at


Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M, Bennell KL. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2015;(1):CD004376.


show all references

1. Centers for Disease Control and Prevention. Osteoarthritis. Accessed April 24, 2015....

2. Sinusas K. Osteoarthritis: diagnosis and treatment [published correction appears in Am Fam Physician. 2012;86(10):893]. Am Fam Physician. 2012;85(1):49–56.

3. Hochberg MC, Altman RD, April KT, et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken). 2012;64(4):465–474.

4. Zhang W, Nuki G, Moskowitz RW, et al. OARSI recommendations for the management of hip and knee osteoarthritis: part III: changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthritis Cartilage. 2010;18(4):476–499.

These are summaries of reviews from the Cochrane Library.

This series is coordinated by Corey D. Fogleman, MD, Assistant Medical Editor.

A collection of Cochrane for Clinicians published in AFP is available at


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