Preventing Knee Osteoarthritis in People at Risk: Trial Evidence and the Mechanics of Joint Loading

Physical therapists and physical therapist assistants who see patients carrying knee osteoarthritis risk factors — overweight or obesity, a previous knee injury, or lower limb muscle weakness — and who want an accurate account of what prevention research currently supports.

Physical therapists and physical therapist assistants in outpatient orthopedics, sports, hospital-based and community wellness settings. Physical therapist assistants may take this course; the plan of care, evaluation and diagnosis remain the physical therapist’s responsibility, and assistants carry out the interventions selected under the physical therapist’s direction and supervision.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

This course reports the findings of two published papers and does not introduce claims beyond them.

Almeida Silva HJ, Perea J, Dantas G, Ferrari AV, Wolden M, Salvini TF, de Campos TF. Intervention Strategies for Preventing Knee Osteoarthritis: A Systematic Review. JOSPT Open. 2026;4(3):264-275. doi:10.2519/josptopen.2026.0155

Jahn J, Ehlen QT, Huang CY. Finding the Goldilocks Zone of Mechanical Loading: A Comprehensive Review of Mechanical Loading in the Prevention and Treatment of Knee Osteoarthritis. Bioengineering (Basel). 2024;11(2). doi:10.3390/bioengineering11020110

After completing this course, you will be able to:

1. Describe which prevention strategy the JOSPT Open systematic review found may reduce the risk of developing knee osteoarthritis pain, in which population, and how certain the review authors were about the remaining strategies.
2. Explain how the Bioengineering comprehensive review accounts for body weight, previous knee injury and muscle weakness as mechanical contributors to knee and post-traumatic osteoarthritis.
3. Distinguish what the trial evidence can support from what only the mechanical loading literature describes, and state where the two papers diverge.

1. Start Here: Course Overview and How to Earn Credit
2. Part One: Prevention Trials for Knee Osteoarthritis
3. Who the Prevention Trials Enrolled
4. How the Review Searched, Selected and Appraised the Trials
5. Lifestyle Programs, Diet and Exercise, Supplements and an Injected Drug: What Was Found
6. Risk of Bias, Missing Trials and the Limits of the Prevention Evidence
7. Part Two: Mechanical Loading in Knee and Post-Traumatic Osteoarthritis
8. How Mechanical Load Becomes a Biological Signal at the Knee
9. Loads Measured During Walking, Squatting, Leg Extension and Landing
10. The Goldilocks Zone: Too Little, Too Much and In Between
11. Offloading the Medial Compartment: Gait Changes, Bracing and Wedges
12. Bringing It Together
13. Where the Two Papers Agree
14. Where the Two Papers Diverge, and Which Paper Found What
15. What a Physical Therapy Plan of Care Can Draw From Both
16. What Remains Unanswered in Knee Osteoarthritis Prevention
17. Key Takeaways
18. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 1.0 contact hour (60 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. Almeida Silva HJ, Perea J, Dantas G, Ferrari AV, Wolden M, Salvini TF, de Campos TF. Intervention Strategies for Preventing Knee Osteoarthritis: A Systematic Review. JOSPT Open. 2026;4(3):264-275. doi:10.2519/josptopen.2026.0155
2. Jahn J, Ehlen QT, Huang CY. Finding the Goldilocks Zone of Mechanical Loading: A Comprehensive Review of Mechanical Loading in the Prevention and Treatment of Knee Osteoarthritis. Bioengineering (Basel). 2024;11(2). doi:10.3390/bioengineering11020110