The Effectiveness of Joint Mobilization as a Monotherapy in the Management of Knee Osteoarthritis: A Systematic Review

Osteoarthritis is a progressive degenerative joint disease that most commonly affects the knee, primarily associated with chronic pain and functional decline. Knee osteoarthritis (KOA) is highly prevalent and its incidence is projected to increase substantially in the coming decades, underscoring the need for effective noninvasive management strategies. Joint mobilization has been widely used to alleviate KOA symptoms, yet its effectiveness as a stand-alone intervention remains unclear. This systematic review, conducted in accordance with PRISMA guidelines, examined the effectiveness of joint mobilization techniques as monotherapy in the management of KOA. Searches were performed in PubMed, PEDro and Scopus, yielding 15 eligible studies (12 clinical trials and 3 case series) with a total of 564 participants. Methodological quality was appraised using the 11-point PEDro scale. The included studies consistently indicated that joint mobilization is a safe intervention that yields clinically meaningful improvements in pain and function among patients with mild to moderate KOA when appropriately applied. Nevertheless, the overall quality of evidence was moderate, with generally short follow-up periods and considerable heterogeneity across the applied techniques and protocols. In conclusion, joint mobilization appears to be a valuable conservative option for KOA management, but the evidence base is limited by methodological weaknesses and lack of long-term outcomes. Future research should focus on standardized protocols, durability of effects and broader outcomes, including psychological and quality-of-life measures.