Investigation of exercise, nutrition, and high tibial osteotomy interventions for patients with medial dominant knee osteoarthritis
type: CreativeWork
description: Purpose: To evaluate the effectiveness of two distinct interventions in improving outcomes for patients with knee osteoarthritis (OA) and varus alignment: 1) a 12-week minimally supervised therapeutic exercise program with nutrition recommendations, 2) and high tibial osteotomy (HTO). Methods: This dissertation involved four studies. Participants were recruited as part of two separate ongoing prospective cohort studies evaluating clinical, biomechanical, and physiological outcomes following a) a 12-week exercise and nutrition program (studies 1-2) or b) HTO (studies 3-4) for knee OA. For studies 1 & 2, we evaluated change in physiological measures (body composition, muscle strength, gait biomechanics), patient-reported measures (pain, function, quality of life, perceived exertion) and performance-based measures, and explored associations among variables. For studies 3 & 4, we evaluated responder criteria at 2 years after HTO, the rate of conversion from HTO to total knee replacement (TKR), and changes in patient-reported outcomes and gait biomechanics at 2, 5 and 10 years after HTO. We also evaluated associations between demographics and biomechanics with various clinical outcomes (i.e., responder criteria, TKR, clinically important improvements in patient-reported outcomes). Results: For the exercise and nutrition program, patients worked harder while experiencing decreases in exercise-induced pain. Patients also experienced substantial improvements in physiological measures (body composition, muscle strength, gait speed), and patient-reported and performance-based outcomes. While physiological measures were associated with patient-reported and performance-based outcomes, magnitudes of association were small. Following HTO, 78% of patients were responders to surgery at 2 years. There were also 5% of patients who went on to a TKR at 5 years, and 20% at 10 years after HTO. Substantial improvements in pain and function, and reductions in knee joint moments (i.e., >40%…
abstract: Purpose: To evaluate the effectiveness of two distinct interventions in improving outcomes for patients with knee osteoarthritis (OA) and varus alignment: 1) a 12-week minimally supervised therapeutic exercise program with nutrition recommendations, 2) and high tibial osteotomy (HTO). Methods: This dissertation involved four studies. Participants were recruited as part of two separate ongoing prospective cohort studies evaluating clinical, biomechanical, and physiological outcomes following a) a 12-week exercise and nutrition program (studies 1-2) or b) HTO (studies 3-4) for knee OA. For studies 1 & 2, we evaluated change in physiological measures (body composition, muscle strength, gait biomechanics), patient-reported measures (pain, function, quality of life, perceived exertion) and performance-based measures, and explored associations among variables. For studies 3 & 4, we evaluated responder criteria at 2 years after HTO, the rate of conversion from HTO to total knee replacement (TKR), and changes in patient-reported outcomes and gait biomechanics at 2, 5 and 10 years after HTO. We also evaluated associations between demographics and biomechanics with various clinical outcomes (i.e., responder criteria, TKR, clinically important improvements in patient-reported outcomes). Results: For the exercise and nutrition program, patients worked harder while experiencing decreases in exercise-induced pain. Patients also experienced substantial improvements in physiological measures (body composition, muscle strength, gait speed), and patient-reported and performance-based outcomes. While physiological measures were associated with patient-reported and performance-based outcomes, magnitudes of association were small. Following HTO, 78% of patients were responders to surgery at 2 years. There were also 5% of patients who went on to a TKR at 5 years, and 20% at 10 years after HTO. Substantial improvements in pain and function, and reductions in knee joint moments (i.e., >40%…
author: Primeau, Codie
language: en_ca
keywords: knee osteoarthritis, exercise, nutrition, high tibial osteotomy, varus alignment, knee joint moments
date published: 2022-10-27
date modified: 2026-07-27T21:56:07Z
provider: Western University
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: The University of Western Ontario

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property ID: Handle
value: https://hdl.handle.net/20.500.14721/32608