Impact of Integrated Kinetic Chain Correction Protocol on Chronic Knee OA; A Preventive Prospect - Case Report

Abstract

Knee Osteoarthritis is a most prevalent disease among older adults increasing the economic burden. A 68-year-old male presented with diagnosed bilateral medial knee osteoarthritis at stage 2, with limited functional activity due to more involvement of the dominant leg. Subjective examination revealed knee pain on numeric rating scale at 8 and on WOMAC to be 16. Further, thorough physical examination revealed multiple musculoskeletal changes including excessive lumbar spine lordosis, anterior pelvic tilt, tightened hip capsule, and weak hip musculature resulting in decreased ROM of hip, knee and ankle joints. After assessment a comprehensive strategy combining conservative knee OA management i.e. heat therapy, stretching and mobilization with comprehensive lower limb kinetic chain correction including hip, knee and ankle musculature strengthening and adjustment of LOG to its normal, was designed to treat the patient. Symptomatically, after 5 weeks treatment pain was significantly improved to 5 on NPRS and 9 on WOMAC with a significant decrease in stiffness and inflammation and increase in ROM, and functional activity. This case report revealed that addressing lower limb kinetic chain in combination of conservative knee OA management can produce promising results. However, a randomized controlled trial is required to confirm the validity of this treatment regime. Keywords: Chronic, Knee, Osteoarthritis, Kinetic Chain, Strengthening, Capsular Release