Bilal UYSAL, Ayşegül KETENCİ
Annals of Clinical and Analytical Medicine - 2026;17(10):1011-1016
Aim: This study compared isokinetic strengthening and home-based exercise combined with intra-articular hyaluronic acid (IAHA) and evaluated the additional benefits of exercise over IAHA alone in knee osteoarthritis (OA). Methods: In this randomized controlled trial, 54 patients with knee OA were assessed; five were excluded before randomization because of knee joint infection ( n = 1), major trauma or surgery ( n = 1), or voluntary withdrawal ( n = 3). The remaining 49 patients were randomized to IAHA plus isokinetic strengthening, IAHA plus home-based exercise, or IAHA alone, and all completed follow-up. IAHA was administered weekly for 3 weeks. The isokinetic group completed 12 supervised sessions over 4 weeks, whereas the home-based group exercised twice daily, 5 days/week, for 4 weeks. Outcomes were assessed at baseline, week 4, and 6 months using the visual analog scale, Western Ontario and McMaster Universities Osteoarthritis Index, Lequesne knee index, Health Assessment Questionnaire, mean absolute angular error, and knee extensor and flexor peak torque at 60 derece/s and 180 derece/s. Results: Baseline characteristics were comparable among groups. All groups showed significant improvements in pain, function, and proprioception over time. Between-group analyses favored isokinetic strengthening for pain, disability, and proprioception after treatment and/or at 6 months. Knee extensor strength improved in both exercise groups, with more consistent gains in the isokinetic group ( P < .05). Conclusion: IAHA improved symptoms in knee OA, while exercise provided additional neuromuscular benefits. Isokinetic strengthening produced greater improvements in selected outcomes, whereas home-based exercise remained a practical option.
