Results of the novel Shalby knee manipulation technique to relieve pain and disability in early osteoarthritis of the knee: A pilot study

Background and Aims: The effectiveness of knee manipulation as a treatment for acute medial knee pain due to early knee osteoarthritis (EOA) has seldom been reported. This study analyzed the effect of the novel Shalby knee manipulation technique on medial pain and disability in patients with EOA. Methods: This prospective pilot study was conducted on patients with acute medial knee pain due to EOA. The manipulation technique was performed in all patients by an orthopedic surgeon at an outpatient clinic of an arthroplasty center. Visual Analog Scale (VAS) score, Knee Society Score (KSS) were recorded pretreatment, immediate posttreatment, and at the end of 1 month, 3 months, and 6 months after the manipulation. Results: In 56 knees which underwent knee manipulation, the mean pretreatment VAS and KSS scores significantly reduced ( P < 0.0001) immediately postmanipulation. At 1-month, 3-month, and 6-month follow-up, the mean VAS and KSS scores were similar to immediate postmanipulation values. Pretreatment, 7% of the knees had a VAS score ≤3 whereas 62.5% of the knees immediate posttreatment, 69% of the knees at 1-month posttreatment, 62% of the knees at 3-month posttreatment, and 67.5% of the knees at 6-month posttreatment had a VAS score ≤3. Conclusion: The novel Shalby knee manipulation technique helped achieve significant improvement in pain and function which was maintained at the end of 6 months posttreatment in 67.5% of the knees in patients with EOA. However, the results of this pilot study should be interpreted in light of its design limitations and needs validation by a randomized controlled trial.