Work

Comparative Effectiveness of Combined Orthotic and Physiotherapy Interventions Versus Monotherapy in the Management of Knee Osteoarthritis on Clinical Parameters: A Systematic Review of Randomized Controlled Trials

Year: 2026

Type: review

Abstract: Background and Aims: Knee osteoarthritis (OA) is a common degenerative joint disease affecting 22.9% of individuals over 40 years of age, causing pain and functional impairment. Orthotic devices and physiotherapy are standard treatments, but their combined effectiveness compared with that of monotherapy is unclear. This systematic review aimed to evaluate the effectiveness of combined orthotic and physiotherapy interventions versus monotherapy in improving clinical (e.g., pain, function) and quality of life (QOL) outcomes in knee OA patients. Methods: Following the PRISMA 2020 guidelines, a comprehensive search was conducted across four databases for studies published until September 7, 2025. The review included Randomized Controlled Trials (RCTs) that specifically compared the outcomes of combined orthotic and physiotherapy interventions versus monotherapy. A narrative synthesis was performed due to the heterogeneity among the studies. Results: Four RCTs involving 240 participants were included. Monotherapy with orthotics or physiotherapy significantly improved clinical parameters such as pain and function. Combined interventions showed enhanced benefits in some cases, although the results varied. The risk of bias ranged from low to moderate in RCTs. Conclusion: Both orthotic and physiotherapy interventions are effective for knee OA, with combined approaches potentially offering additional benefits. However, heterogeneity and bias limit the certainty of the evidence. Future research should focus on large-scale, stratified RCTs to enhance the generalizability of the findings and inform personalized treatment strategies.

Source: Health Science Reports

DOI: 10.1002/hsr2.72049

Authors: Mahsa Zangi, Mahmood Bahramizadeh, Mobina Khosravi, Rasha Atlasi, Mokhtar Arazpour, Koorosh Barati

Institutions: University of Social Welfare and Rehabilitation Sciences, Shahid Beheshti University, Shahid Beheshti University of Medical Sciences, Mashhad University of Medical Sciences

Language: English

Topic: Osteoarthritis Treatment and Mechanisms

Subfield: Rheumatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,280