Skip to content

Patients › General-Health

Pagpapanatili ng Aktibidad para sa Kalusugan ng Kasu-kasuan

PDF Evidence

Why physical activity protects joints and tendons, how exercise helps osteoarthritis and recovery, and how to stay active safely.

Updated Aug 2026
Isang taong naglalakad nang mabilis.
Ang regular na paggalaw ay nagpapanatiling malusog ang mga kasukasuan, tendon, at kalamnan, at tumutulong sa paggaling — ang galaw ay gamot. Kieran Hirpara 4.0

Ang pahinang ito ay isinalin ng makina at hindi pa nasusuri ng isang doktor. Ang bersyong Ingles ang siyang opisyal.

Ano ang nararamdaman mo

Maaaring mapansin mong mahigpit o masakit ang iyong kasukasuan pagkatapos mag-ehersisyo o maging aktibo. Madalas itong kumikislap sa gabi o kapag gising ka pa lang sa umaga. Maaaring maging mahirap ang mga simpleng gawain sa araw-araw. Maaaring mahirapan kang umabot sa likod ng iyong likod upang isara ang bra. Ang pagtutukoy ng iyong kamiseta ay maaari ring maging awkward o masakit.

Ang ehersisyo ay makakatulong sa pamamahala ng mga sintomas na ito. Kung magsisimula ka sa isang programa ng ehersisyo sa loob ng 12 linggo pagkatapos ng iyong total knee replacement, malamang na makikita mo ang mga pagpapabuti sa iyong kakayahang gumalaw. Ang mga maagang pagsisikap na ito ay nakatuon sa functional performance. Kung magpapatuloy ka sa pag-ehersisyo ng higit sa 12 linggo, makakakuha ka ng mas malakas na kalamnan at mas flexible na mga kasukasuan.

Para sa mga may wear-and-tear arthritis sa tuhod, ang aerobic exercise ay makakatulong sa pagpapabuti ng fitness ng iyong puso at baga. Ang ehersisyo ay maaari ring makatulong sa pagbabawas ng sakit at pagpapabuti ng function, bagama't iba-iba ang antas ng benepisyo. Mahalagang malaman na ang pag-monitor ng iyong aktibidad gamit ang wearable trackers ay hindi nagbabago ng iyong pakiramdam tungkol sa iyong joint function o kabuuang kalusugan.

Sa ilang kaso, tulad ng trigger finger, ang splint at ehersisyo ay maaaring magbigay ng short-term relief. Para sa wrist osteoarthritis, ang mga programa ng ehersisyo ay maaaring makatulong sa pamamahala ng mga sintomas sa loob ng panahon, at napakakaunti lamang ang nangangailangan ng surgery sa loob ng dalawang taon. Bagama't kapaki-pakinabang ang mga ehersisyong ito, ang karamihan sa mga pagkakaiba sa mga resulta para sa mga disorder sa kamay o siko ay maaaring hindi umabot sa antas ng pagbabago na nararamdaman mong klinikal na mahalaga para sa iyo.

Ang iyong surgeon ang gabay sa tamang uri at dami ng aktibidad. Ang layunin ay panatilihin ang iyong paggalaw nang ligtas habang pinagmumulan ang mga limitasyon ng iyong katawan. makinig sa iyong kasukasuan. Kung ang isang aktibidad ay nagdudulot ng matulis na sakit, huminto at magpahinga. Ang consistent, gentle movement ay karaniwang mas mabuti kaysa sa pagpilit sa kabila ng discomfort.

Ano ang nangyayari talaga

Ang iyong mga kasukasuan ay dinisenyo upang gumalaw nang maayos. Ang kartilago ay nagsisilbing shock absorber o makinis na patong sa mga dulo ng iyong mga buto. Kapag nabasag ang tissue na ito, tulad sa osteoarthritis, ang kasukasuan ay nagiging matigas at masakit. Ang proseso ng pagkasira na ito ay nagpapababa ng iyong kakayahang gumalaw nang malaya.

Ang ehersisyo ay tumutulong sa pamamahala ng mga pagbabagong ito. Para sa mga taong may osteoarthritis sa tuhod, ang aerobic exercise ay nagpapabuti ng cardiopulmonary fitness. Ibig sabihin, mas epektibo ang pagtatrabaho ng iyong puso at baga habang gumagalaw. Ang regular na aktibidad ay maaari ring tumulong sa pagbawas ng sakit at pagpapabuti ng function, bagama't iba-iba ang antas ng pagpapabuti.

Pagkatapos ng surgery para sa joint replacement, mahalaga ang timing. Kung magsisimula ka ng mga intervention sa ehersisyo sa loob ng 12 linggo pagkatapos ng total knee arthroplasty, pangunahing nakikita mo ang pagpapabuti sa functional performance. Tumutulong ito upang mabalik ka sa mga pang-araw-araw na gawain. Kung ang mga intervention sa ehersisyo ay tumatagal ng higit sa 12 linggo pagkatapos ng total knee arthroplasty, mas malaki ang nakukuha mong pagpapabuti sa lakas ng kalamnan at flexibility ng kasukasuan. Ang mas malalakas na kalamnan ay mas mahusay na sumusuporta sa kasukasuan, na nagbabawas ng strain sa nasirang kartilago.

Para sa ibang mga kasukasuan, ang ebidensya ay halo-halo. Ang self-monitoring ng pisikal na aktibidad gamit ang wearable activity trackers ay walang epekto sa perceived joint function o health-related quality of life sa mga taong may osteoarthritis sa balakang at tuhod. Katulad nito, ang karamihan sa mga pagkakaiba sa functional outcomes mula sa mga programa ng scapular exercise para sa mga disorder sa kamay, pulso, o siko ay hindi umabot sa minimum na threshold upang ituring na clinically important.

Sa ilang mga kaso, tulad ng trigger finger, ang proximal interphalangeal joint orthosis at therapeutic exercise ay nagpapakita ng feasibility at short-term clinical improvement. Gayunpaman, hindi ito maaaring itaguyod ang kanyang kahusayan kumpara sa ibang mga conservative treatments dahil sa kawalan ng control group. Para sa wrist osteoarthritis, kaunti ang mga kalahok sa parehong grupo na nangangailangan ng surgery sa loob ng 24 buwan sa isang randomized controlled trial ng neuromuscular exercise therapy. Ipinapakita nito na ang mga programang ehersisyo ay maaaring mag-ambag sa pamamahala ng sintomas sa paglipas ng panahon.

Maaaring hindi ibigay ng iyong surgeon ang prioridad sa mga outcomes ng total hip arthroplasty lamang para sa mga pasyente na may malalang sintomas ng osteoarthritis sa balakang, bagama't nangangailangan ito ng kumpirmasyon sa isang trial. Ang layunin ay panatilihing aktibo ka at pamahalaan ang mga sintomas sa pamamagitan ng paggalaw, na naaayon sa iyong tiyak na kasukasuan at kondisyon.

Ano ang inaasahan

Ang iyong paglalakbay patungo sa mas mahusay na kalusugan ng kasu-kasuan ay nakadepende nang malaki sa kung paano at kailan ka magsisimulang gumalaw. Kung naging karanasan mo ang total knee replacement, ang pagsisimula ng ehersisyo sa loob ng 12 linggo ay tumutulong sa iyo na mabawi ang pang-araw-araw na kakayahan. Kung patuloy kang gagawa ng mga ehersisyong ito sa higit sa 12 linggo, makikita mo ang mas malaking pag-unlad sa lakas ng kalamnan at flexibility ng kasu-kasuan. Ang istilong ito ay nagtatayo ng suporta na kailangan ng iyong bagong kasu-kasuan upang tumagal.

Para sa mga nagmamaneho ng wear-and-tear arthritis sa tuhod, ang regular na aerobic exercise ay nagpapabuti sa fitness ng puso at baga. Maaari mo ring mapansin ang mas kaunting sakit at mas mahusay na galaw. Gayunpaman, hindi sapat ang ebidensya upang pangakuhin na ang mga pagbabagong ito ay magdudulot ng malaking pag-unlad sa buhay para sa lahat. Ito ay isang kapaki-pakinabang na kasangkapan, ngunit magkakaiba ang resulta.

Kung ikaw ay nag-iisip ng total hip replacement, huwag hintayin hanggang sa maging seryoso ang iyong mga sintomas. Habang sinusuportahan ng kasalukuyang datos ang pananaw na ito, kailangan pa itong kumpirmahin sa mga clinical trial. Ang maagang aksyon ay madalas na nagdudulot ng mas maayos na resulta.

Maaaring magtanong ka kung ang pag-track ng iyong steps ay magbabago sa iyong pananaw. Ang paggamit ng wearable activity trackers upang i-monitor ang iyong galaw ay hindi nagpapabuti sa pakiramdam mo tungkol sa function ng iyong kasu-kasuan o sa kabuuang kalidad ng buhay. Ipinapakita ng data na walang makabuluhang benepisyo mula sa self-monitoring na ito para sa hip at knee arthritis.

Para sa ibang mga kasu-kasuan, tulad ng kamay, pulso, o siko, maghalong resulta ang mga programang ehersisyo. Karamihan sa mga pag-unlad sa pang-araw-araw na function mula sa mga ehersisyong scapular (shoulder blade) ay hindi umaabot sa threshold upang maging clinically important. Katulad nito, habang ang mga orthoses at ehersisyo ay maaaring tumulong sa trigger finger sa maikling panahon, hindi ito nabibigyang-katibayan na mas mahusay kaysa sa ibang mga conservative treatments.

Sa mga kaso ng wrist osteoarthritis, kaunti ang mga tao na nangangailangan ng surgery sa 24 buwan kapag sumusunod sa isang neuromuscular exercise program. Ipinapahiwatig nito na ang consistent na ehersisyo ay maaaring tumulong sa pamamahala ng mga sintomas sa paglipas ng panahon at maaaring magpaliban o maiwasan ang pangangailangan para sa surgical intervention. Ang iyong surgeon ay tutulong sa iyo na pumili ng tamang landas batay sa iyong partikular na kasu-kasuan at mga sintomas.

Reviewed by Kieran Hirpara · 13 June 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Exercise interventions implemented ≤12 weeks after total knee arthroplasty primarily improve functional performance [1].
  • Exercise interventions lasting >12 weeks after total knee arthroplasty result in greater gains in muscle strength and joint flexibility [1].
  • Total hip arthroplasty outcomes should not be prioritized only for patients with severe hip osteoarthritis symptoms, though confirmation in a trial is required [2].
  • Aerobic exercise elicits improvements in cardiopulmonary fitness for people with knee osteoarthritis [3].
  • Exercise may improve pain and function in knee osteoarthritis with low to moderate certainty, but it is uncertain whether these differences are clinically important [5].
  • Self-monitoring physical activity with wearable activity trackers does not have any effect on perceived joint function or health-related quality of life in people with hip and knee osteoarthritis [7].
  • Scapular exercise programs for hand, wrist, or elbow disorders result in functional outcome differences that most often do not reach the minimum threshold to be considered clinically important [8].
  • Proximal interphalangeal joint orthosis and therapeutic exercise demonstrate feasibility and short-term clinical improvement for trigger finger, but cannot establish superiority over other conservative treatments due to the absence of a control group [9].
  • Neuromuscular exercise therapy contributes to symptom management in wrist osteoarthritis over time, with few participants requiring surgical conversion at 24 months [10].

How It Works

  • Exercise may improve pain and function in knee osteoarthritis with low to moderate certainty [5].
  • It is uncertain whether the improvements in pain and function from exercise for knee osteoarthritis are clinically important [5].
  • The addition of wearable activity tracker use did not have any effect on perceived joint function or health-related quality of life in people with hip and knee osteoarthritis [7].
  • Most differences in functional outcomes from scapular exercise programs for hand, wrist, or elbow disorders did not reach the minimum threshold to be considered clinically important [8].
  • Proximal interphalangeal joint orthosis and therapeutic exercise demonstrate feasibility and short-term clinical improvement for trigger finger management [9].
  • Few participants in either group required surgery at 24 months in a trial of neuromuscular exercise therapy for wrist osteoarthritis, indicating that exercise programs may contribute to long-term symptom management [10].
  • The addition of whole-body vibration to exercise therapy led to greater improvements in several outcomes for end-stage knee osteoarthritis, suggesting it may optimize the benefits of exercise therapy [12].
  • Moderate treadmill exercise following an initial period of short-term immobilization has a positive impact on tendon-bone interface healing after anterior cruciate ligament reconstruction [13].
  • Prolonged immobilization has a detrimental effect on physical recovery following anterior cruciate ligament reconstruction [13].
  • Pain science education may act as a mechanism of action for exercise interventions in people with knee or hip osteoarthritis [14].
  • Pain science education is less successful when delivered standalone compared to when it is part of an exercise intervention [14].
  • There is heterogeneity in functional recovery among joint arthroplasty patients, highlighting the importance of a personalised, data-driven approach to post-operative care [15].

What the Evidence Shows

  • Findings question whether total hip arthroplasty should be prioritized only for patients with severe hip osteoarthritis symptoms, though confirmation in a trial is required [2].
  • Most differences in functional outcomes for patients with hand, wrist, or elbow disorders following a scapular exercise program did not reach the minimum threshold to be considered clinically important [8].
  • Proximal interphalangeal joint orthosis and therapeutic exercise demonstrate feasibility and short-term clinical improvement for trigger finger management, but cannot establish superiority over other conservative treatments due to the absence of a control group [9].
  • Few participants in either group required surgery at 24 months in a randomized controlled trial of neuromuscular exercise therapy for wrist osteoarthritis, indicating that exercise programs may contribute to long-term symptom management [10].
  • The document for Fu’s subcutaneous needling versus bracing combined with exercise therapy is a study protocol and does not report results or conclusions [11].
  • The addition of whole-body vibration to exercise therapy led to greater improvements in several outcomes for end-stage knee osteoarthritis, suggesting it may be a valuable adjunct to optimize exercise benefits [12].
  • Moderate treadmill exercise following an initial period of short-term immobilization has a positive impact on tendon-bone interface healing after anterior cruciate ligament reconstruction in a murine model [13].
  • Prolonged immobilization has a detrimental effect on physical recovery following anterior cruciate ligament reconstruction in a murine model [13].
  • Pain science education may act as a mechanism of action for exercise interventions in people with knee or hip osteoarthritis, and is less successful when delivered standalone [14].
  • An individually tailored, supervised prehabilitation program resulted in superior improvements in perceived knee function compared to a self-administered program before anterior cruciate ligament reconstruction [16].
  • Both combined mode kinetic chain exercises with core strengthening and combined kinetic chain exercise only reduced pain, improved knee flexion and extension, and improved overall quality of life in patients with knee osteoarthritis [17].
  • Progressive tendon-loading eccentric exercise therapy in athletes with patellar tendinopathy resulted in statistically significant decreases in center of pressure velocity and increases in Y-Balance Test reach distances compared to baseline [18].
  • Mobile game-based home exercise programs may be a potentially effective option for thumb rehabilitation, with significantly higher adherence observed compared to standard home exercise programs [19].
  • Ankle pump exercises significantly reduce the incidence of deep vein thrombosis and increase venous haemodynamic parameters—specifically maximum venous outflow and maximum venous capacity—in patients undergoing lower limb orthopaedic surgery [20].
  • There is moderate-certainty evidence that Pilates and Tai Chi may be the most effective mind–body exercises for improving pain and physical function in knee osteoarthritis [21].
  • Tai Chi may be the best mind–body exercise for improving quality of life in knee osteoarthritis [21].

Practical Considerations

  • Total hip arthroplasty should not necessarily be prioritized only for patients with severe hip osteoarthritis symptoms, although this requires confirmation in a trial [2].
  • Few participants in either group required surgery at 24 months in a randomized controlled trial of neuromuscular exercise therapy for wrist osteoarthritis, indicating that exercise programs may contribute to symptom management over time [10].
  • The addition of whole-body vibration to exercise therapy led to greater improvements in several outcomes for end-stage knee osteoarthritis, suggesting it may be a valuable adjunct to optimize the benefits of exercise therapy [12].
  • Heterogeneity in functional recovery among joint arthroplasty patients underscores the importance of a personalized, data-driven approach to post-operative care to optimize long-term outcomes [15].

Key Evidence

  • [L1] The interventions implemented at ≤12 weeks primarily improved the functional performance, whereas those lasting >12 weeks resulted in greater gains in the muscle strength and joint flexibility. [1] (10.1186/s13018-025-06430-7)
  • [L3] These findings question whether THA should be prioritized only for those patients who have severe hip OA symptoms, but require confirmation in a trial. [2] (10.1016/j.arth.2025.04.032)
  • [L1] These results support the hypothesis that aerobic exercise can elicit improvements in cardiopulmonary fitness for people with knee OA. [3] (10.1186/s12891-025-08746-1)
  • [L1] Exercise may improve pain and function with low to moderate certainty, but it is uncertain whether differences are clinically important. [5] (10.1097/corr.0000000000003476)
  • [L1] The addition of WAT-use did not have any effect on perceived joint function or HRQoL. [7] (10.1186/s12891-024-08238-8)
  • [L1] However, most of these differences did not reach the minimum threshold to be considered clinically important. [8] (10.1016/j.jht.2024.07.006)
  • [L4] Because of the absence of a control group, these findings demonstrate feasibility and short-term clinical improvement but cannot establish superiority over other conservative treatments. [9] (10.1016/j.jhsg.2026.101038)
  • [L1] Nevertheless, few participants in either group required surgery at 24 months, indicating that both exercise programs may contribute to symptom management over time. [10] (10.1186/s12891-025-09463-5)
  • [Paper] This document is a study protocol outlining the design of a randomized controlled trial to compare Fu's subcutaneous needling with bracing combined with exercise therapy; it does not report results or conclusions. [11] (10.1186/s13018-026-06719-1)
  • [L3] The addition of WBV to exercise therapy led to greater improvements in several outcomes, suggesting that WBV may be a valuable adjunct to optimize the benefits of exercise therapy. [12] (10.1186/s42836-025-00301-6)
  • [L5] Moderate treadmill exercise following an initial period of short-term immobilization has a positive impact on tendon-bone interface healing, whereas prolonged immobilization has a detrimental effect on physical recovery. [13] (10.1177/2325967125s00320)
  • [L1] PSE may act as a mechanism of action for exercise interventions, and is less successful delivered standalone. [14] (10.1186/s12891-025-09313-4)
  • [L3] The findings highlight heterogeneity in functional recovery and underscore the importance of a personalised, data-driven approach to post-operative care to optimise long-term outcomes. [15] (10.1186/s42836-025-00339-6)
  • [L1] An individually tailored, supervised prehabilitation program resulted in superior improvements in perceived knee function compared to a self-administered program. [16] (10.1177/2325967126s00041)
  • [L2] The study concluded that both the experimental group receiving core strengthening exercises with combined mode kinetic chain exercises and the control group receiving combined kinetic chain exercise only reduced pain, improved knee flexion and extension, and improved the overall quality of life of patients with knee Osteoarthritis. [17] (10.1186/s12891-026-09531-4)
  • [L2] The intervention group showed statistically significant decreases in center of pressure velocity and increases in Y-Balance Test reach distances compared to baseline. [18] (10.1016/j.jisako.2026.101105)
  • [L2] Mobile game-based home exercise programs may be considered a potentially effective option in thumb rehabilitation and, at the very least, not inferior to standard home exercise programs, with significantly higher adherence to home exercises observed in the mobile game group. [19] (10.1177/17589983251387079)
  • [L1] This meta-analysis provides Level I evidence that ankle pump exercises significantly reduce the incidence of deep vein thrombosis (DVT) and increase venous haemodynamic parameters—specifically maximum venous outflow (MVO) and maximum venous capacity (MVC)—in patients undergoing lower limb orthopaedic surgery. [20] (10.1186/s13018-025-06236-7)
  • [L1] There is moderate-certainty evidence that Pilates and Tai Chi may be the most effective mind–body exercises for improving pain and physical function in knee osteoarthritis, while Tai Chi may be the best for improving quality of life. [21] (10.1186/s13018-025-05682-7)

References

[1] Changes in knee outcome measures following later-stage exercise interventions implemented ≤ 12 weeks vs. > 12 weeks after total knee arthroplasty: a systematic review and meta-analysis. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06430-7

[2] Total Hip Arthroplasty versus Education and Exercise: A Secondary Analysis of Propensity Matched Data Comparing Outcomes Across Hip Osteoarthritis Symptom Severity. The Journal of Arthroplasty. 2025. DOI: 10.1016/j.arth.2025.04.032

[3] Effect of aerobic exercise on cardiopulmonary fitness among people with knee osteoarthritis: a systematic review and meta-analysis. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-08746-1

[5] Cochrane in CORR®: Exercise for Osteoarthritis of the Knee. Clinical Orthopaedics & Related Research. 2025. DOI: 10.1097/corr.0000000000003476

[7] Effects of self-monitoring physical activity with wearable activity trackers on perceived joint function and health-related quality of life in people with hip and knee osteoarthritis: a secondary analysis of a cluster-randomised clinical trial. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-024-08238-8

[8] Effectiveness of a scapular exercise program on functional outcomes in patients with hand, wrist or elbow disorders: A comprehensive systematic review with meta-analysis. Journal of Hand Therapy. 2025. DOI: 10.1016/j.jht.2024.07.006

[9] Effectiveness of Proximal Interphalangeal Joint Orthosis and Therapeutic Exercise in the Management of Trigger Finger: A Prospective Case Series. Journal of Hand Surgery Global Online. 2026. DOI: 10.1016/j.jhsg.2026.101038

[10] Long-term effects of neuromuscular exercise therapy and the need for surgical conversion in wrist osteoarthritis: 24-month results from a randomized controlled trial. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-09463-5

[11] Fu’s subcutaneous needling versus bracing combined with exercise therapy in the treatment of postacute lateral ankle sprain and the prevention of chronic ankle instability: a randomized controlled trial protocol. Journal of Orthopaedic Surgery and Research. 2026. DOI: 10.1186/s13018-026-06719-1

[12] Improving pain, function and quality of life in end-stage knee osteoarthritis: a patient-preference cohort study on whole-body vibration and exercise as bridging therapies for total knee replacement. Arthroplasty. 2025. DOI: 10.1186/s42836-025-00301-6

[13] Poster 234: Improvement of Tendon-Bone Interface Healing by Moderate Treadmill Exercise Combined with Knee Brace Immobilization Following an Anterior Cruciate Ligament Reconstruction in a Murine Model. Orthopaedic Journal of Sports Medicine. 2025. DOI: 10.1177/2325967125s00320

[14] Pain science education and exercise interventions for people with knee or hip osteoarthritis: a systematic review, content and meta-analysis. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-09313-4

[15] Unsupervised machine learning models reveal two distinct post-operative physical activity profiles among joint arthroplasty patients: a United Kingdom biobank cohort study. Arthroplasty. 2025. DOI: 10.1186/s42836-025-00339-6

[16] Effectiveness of Exercise Prehabilitation Before Anterior Cruciate Ligament Reconstruction on Functional Outcomes – A Single-Blinded Randomized Controlled Trial: Prevention, Prehab and Rehab. Orthopaedic Journal of Sports Medicine. 2026. DOI: 10.1177/2325967126s00041

[17] Combined mode-kinetic chain exercise with and without core stability exercises on patients with knee osteoarthritis. BMC Musculoskeletal Disorders. 2026. DOI: 10.1186/s12891-026-09531-4

[18] Progressive tendon-loading eccentric exercise therapy in athletes with patellar tendinopathy improves postural control, quadriceps strength, and pain: A randomized clinical trial. Journal of ISAKOS. 2026. DOI: 10.1016/j.jisako.2026.101105

[19] Effects of home exercise-based mobile games on thumb rehabilitation outcomes. Hand Therapy. 2025. DOI: 10.1177/17589983251387079

[20] Effect of postoperative ankle pump exercises on the prevention of deep vein thrombosis and venous hemodynamics following lower limb orthopedic surgery: a meta-analysis of randomized controlled trials. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06236-7

[21] Comparative efficacy of mind–body exercise for pain, function, quality of life in knee osteoarthritis: a systematic review and network meta-analysis. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-05682-7

Creative Commons BY-NC 4.0

CC Creative Commons licence
BY Attribution — you must credit the source
NC NonCommercial — not for commercial use

Attribution-NonCommercial 4.0 International

Creative Commons Corporation ("Creative Commons") is not a law firm and does not provide legal services or legal advice. Distribution of Creative Commons public licenses does not create a lawyer-client or other relationship. Creative Commons makes its licenses and related information available on an "as-is" basis. Creative Commons gives no warranties regarding its licenses, any material licensed under their terms and conditions, or any related information. Creative Commons disclaims all liability for damages resulting from their use to the fullest extent possible.

Using Creative Commons Public Licenses

Creative Commons public licenses provide a standard set of terms and conditions that creators and other rights holders may use to share original works of authorship and other material subject to copyright and certain other rights specified in the public license below. The following considerations are for informational purposes only, are not exhaustive, and do not form part of our licenses.

Considerations for licensors: Our public licenses are intended for use by those authorized to give the public permission to use material in ways otherwise restricted by copyright and certain other rights. Our licenses are irrevocable. Licensors should read and understand the terms and conditions of the license they choose before applying it. Licensors should also secure all rights necessary before applying our licenses so that the public can reuse the material as expected. Licensors should clearly mark any material not subject to the license. This includes other CC- licensed material, or material used under an exception or limitation to copyright. More considerations for licensors: wiki.creativecommons.org/Considerations_for_licensors

Considerations for the public: By using one of our public licenses, a licensor grants the public permission to use the licensed material under specified terms and conditions. If the licensor's permission is not necessary for any reason--for example, because of any applicable exception or limitation to copyright--then that use is not regulated by the license. Our licenses grant only permissions under copyright and certain other rights that a licensor has authority to grant. Use of the licensed material may still be restricted for other reasons, including because others have copyright or other rights in the material. A licensor may make special requests, such as asking that all changes be marked or described. Although not required by our licenses, you are encouraged to respect those requests where reasonable. More considerations for the public: wiki.creativecommons.org/Considerations_for_licensees

Creative Commons Attribution-NonCommercial 4.0 International Public License

By exercising the Licensed Rights (defined below), You accept and agree to be bound by the terms and conditions of this Creative Commons Attribution-NonCommercial 4.0 International Public License ("Public License"). To the extent this Public License may be interpreted as a contract, You are granted the Licensed Rights in consideration of Your acceptance of these terms and conditions, and the Licensor grants You such rights in consideration of benefits the Licensor receives from making the Licensed Material available under these terms and conditions.

Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.