Evidence-Based Assessment of the Knee Joint in Osteoarthritis: A Comprehensive Approach to Diagnosis, Monitoring, and Treatment Planning for Physiotherapists

Background: Knee osteoarthritis (OA) is a prevalent musculoskeletal disorder that causes chronic pain, reduced mobility, and decreased quality of life. Given its progressive nature, an accurate, evidence-based assessment approach is essential for guiding diagnosis, monitoring disease progression, and informing treatment decisions. Traditional assessment methods often vary among clinicians and may lack standardization, potentially affecting patient outcomes. A structured framework that integrates clinical reasoning, validated tools, and imaging can improve the consistency and accuracy of knee OA evaluation. Objective: This study aims to develop a comprehensive, evidence-based assessment framework for knee OA, offering physiotherapists a standardized yet adaptable approach to diagnosis and treatment planning. Methods: The assessment framework was developed through a combination of current clinical practices, expert recommendations, and validated assessment tools. It includes subjective history-taking, physical examination, and functional outcome measures such as the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The role of imaging in specific cases was also considered, with clinical reasoning emphasized to distinguish OA from other knee pathologies. Practitioner feedback was used to evaluate the framework's practicality and effectiveness. Results: The structured framework improves the accuracy and consistency of knee OA assessment by incorporating essential clinical components. It allows for individualized adaptations while maintaining standardized evaluation criteria. Physiotherapists reported increased confidence in diagnosing and monitoring knee OA with this approach. Conclusion: The evidence-based assessment framework standardizes the evaluation of knee OA, aiding early diagnosis, disease monitoring, and treatment planning. Future research should validate its clinical applicability and investigate additional factors, such as psychosocial influences, on OA progression.