A patient with knee osteoarthritis would benefit most from which primary intervention?

• A. Structured exercise program (aerobic and resistance) with weight management
• B. Immediate knee replacement
• C. Prolonged bed rest
• D. Avoidance of physical activity

Answer: (A)

Nonoperative management that combines a structured exercise program with weight management is the best first-line approach for knee osteoarthritis. Strengthening the muscles around the knee, especially the quadriceps and hip stabilizers, improves joint mechanics, reduces pain, and enhances function. Adding aerobic activity improves overall fitness and can further ease symptoms. Weight loss lowers the mechanical load on the knee, which often translates to less pain and better mobility, particularly in overweight individuals. Together, these nonpharmacologic strategies address the biomechanical and conditioning factors that drive OA symptoms.

Surgery, such as knee replacement, is reserved for cases where symptoms remain severe or functional limits persist after conservative measures have been tried. Prolonged bed rest or avoiding physical activity leads to rapid deconditioning, muscle loss, and worse function, so those are not appropriate primary interventions for OA.