Osteo Arthritis of the KneeNCT07657481
Comparison of the Effects of Two Different Exercise Programs on Femoral Cartilage Thickness and Clinical Parameters in Individuals With Knee Osteoarthritis
A study testing Quadriceps Plus Hip Strengthening Exercises and Quadriceps Strengthening Exercises in people with Osteo Arthritis of the Knee, run by Pamukkale University at 1 site in Turkey (Türkiye).
Trial summary
Knee osteoarthritis (OA) is one of the most common joint disorders worldwide and is a leading cause of pain, limited mobility, and functional disability, particularly in the elderly population. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Osteo Arthritis of the Knee
- What is being tested?
- Quadriceps Plus Hip Strengthening Exercises and Quadriceps Strengthening Exercises
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 56 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 20 Aug 2026to 1 Jul 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age ≥18 years
- Diagnosis of knee osteoarthritis according to ACR criteria, Kellgren-Lawrence grade 2-3
- Knee pain for at least 3 months
- Having the physical capacity to perform a home exercise program
- Willingness to provide written informed consent
Who cannot join
- History of knee, hip, or spine surgery
- Active inflammatory arthritis (e.g., rheumatoid arthritis, gout, psoriatic arthritis)
- Intra-articular injection within the last 3 months
- Neurological or neuromuscular disorders
- Body mass index (BMI) > 40 kg/m²
- Pregnancy
- Cardiovascular or orthopedic contraindications preventing participation in a regular exercise program
- Cognitive impairment
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Turkey (Türkiye)1 site
Kütahya Physical Therapy and Rehabilitation Hospital
Kütahya
selma karaçam bayındır, 0 (274) 260 00 43, etik.gir.olmayan@ksbu.edu.tr
Hasan Celtek
About this study
Official title: Comparison of the Effects of Two Different Home Exercise Programs on Femoral Cartilage Thickness and Clinical Parameters in Individuals With Knee Osteoarthritis: A Randomized Controlled Trial
Knee osteoarthritis (OA) is one of the most common joint disorders worldwide and is a leading cause of pain, limited mobility, and functional disability, particularly in the elderly population. According to 2020 data, approximately 654 million individuals aged 40 years and older are affected by knee OA worldwide, with a global prevalence of 22.9% in this age group. In our country as well, OA is reported as the second most common rheumatologic disease. The disease not only negatively affects individuals' quality of life but also creates a significant socioeconomic burden through work loss, hospital admissions, and the need for surgical interventions.
The pathogenesis of knee OA is a complex process involving articular cartilage degeneration, subchondral bone sclerosis, synovial tissue proliferation, and osteophyte formation. Once cartilage damage begins, its capacity for spontaneous healing is extremely limited; therefore, early interventions aimed at slowing or halting disease progression are of critical importance. In this context, non-pharmacological interventions, particularly exercise programs that may contribute to maintaining cartilage integrity, are strongly recommended as first-line treatment options in current clinical guidelines.
Read more
The beneficial effects of exercise therapy on pain and function in patients with knee OA are well documented. However, the structural effects of exercise on femoral cartilage thickness have been relatively less investigated. Tuna et al. evaluated femoral cartilage thickness using ultrasonography in 40 patients with knee OA following a 12-week quadriceps strengthening program and reported statistically significant increases in cartilage thickness in the medial condyle, lateral condyle, and intercondylar region at 3 months. This pioneering study suggests that muscle strengthening programs may have not only symptomatic but also structural benefits. Similarly, Bozan et al. reported a strong positive correlation between quadriceps muscle thickness (rectus femoris + vastus intermedius) and femoral cartilage thickness, supporting the idea that muscle loss parallels cartilage degeneration. However, these studies focused exclusively on the quadriceps muscle, and the effects of hip musculature on femoral cartilage thickness have not been investigated. Recent biomechanical studies indicate that hip abductor and adductor muscles play a critical role in knee joint loading patterns.
Hip abductor muscles provide pelvic stability during gait and directly influence knee adduction moments. Weakness of the gluteus medius leads to contralateral pelvic drop, increasing medial compartment loading on the ipsilateral knee and accelerating medial tibiofemoral cartilage wear. Indeed, Segal et al., using data from the Multicenter Osteoarthritis Study (MOST), demonstrated via MRI that greater hip abductor strength significantly reduces the risk of progression of medial patellofemoral and lateral tibiofemoral cartilage damage. On the other hand, hip adductor muscles are also thought to contribute to knee adduction moments by eccentrically controlling femoral varus motion; however, this relationship has been studied far less compared to quadriceps and abductors.
Systematic reviews and meta-analyses have shown that individuals with knee OA have up to 24% lower isometric hip abductor strength compared to healthy controls. Randomized controlled trials investigating combined hip and quadriceps strengthening programs have reported significant improvements in pain and function. However, none of these studies have used femoral cartilage thickness measured by ultrasonography as a primary outcome.
A review of the current literature reveals that although studies exist examining the effects of quadriceps strengthening on femoral cartilage thickness, no randomized controlled trial has compared hip abductor and adductor strengthening exercises with a quadriceps strengthening program, using ultrasonographic femoral cartilage thickness as the primary outcome measure. This study aims to address this gap. All interventions will be applied as non-invasive home exercise programs, and all measurements will be performed using ultrasonography. Baseline, 1-month, and 3-month assessments will also allow evaluation of the temporal effects of exercise on cartilage structure. The findings are expected to provide scientific evidence regarding the structural protective effects of hip exercises in knee OA rehabilitation and serve as pilot data for future large-scale multicenter studies.
The aim of this study is to compare patients with knee OA receiving quadriceps strengthening exercises alone with those receiving additional hip abductor/adductor strengthening exercises in terms of changes in femoral cartilage thickness, and to evaluate whether there is a correlation between femoral cartilage thickness and the thickness of the rectus femoris, gluteus medius,
- Conditions
- Osteo Arthritis of the Knee
- Being tested
- Quadriceps Plus Hip Strengthening Exercises, Quadriceps Strengthening Exercises
- Keywords
- knee osteoartritis, femoral cartilage thikness, quadriceps strengthening exercises, hip abductor and adductor strengthening exercises
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Quadriceps Plus Hip Strengthening ExercisesOther
quadriceps strengthening exercises combined with hip abductor and adductor strengthening exercises
Quadriceps Strengthening ExercisesOther
quadriceps strengthening exercise program
| Study group | Role | What they receive |
|---|---|---|
| Quadriceps Plus Hip Strengthening Group | Experimental | For 3 months, 3 days per week, participants will perform quadriceps strengthening exercises combined with hip abductor and adductor strengthening exercises.
In addition to all exercises included in the Quadriceps Strengthening Group, participants will perform:
Hip abduction (side-lying position with ankle weights) Clamshell exercise (for gluteus medius activation) Hip adduction (supine position with isometric contraction using a pillow) Side-lying hip abduction with a resistance band Receives: Other: Quadriceps Plus Hip Strengthening Exercises |
| Quadriceps Strengthening Group | Active comparator | For 3 months, 3 days per week, participants will perform a quadriceps strengthening exercise program only.
The program will include:
Knee extension (in a seated position, with and without resistance) Terminal knee extension Straight leg raise Mini squat (0-30° knee flexion) Receives: Other: Quadriceps Strengthening Exercises |
What is being measured
The primary outcome is the main question the study is designed to answer.
Medial femoral condyle cartilage thickness (mm)
All ultrasonographic measurements will be performed using a Clarius L7 HD3 linear high-frequency transducer (7.5-12 MHz) with the knee positioned in 90° flexion in a standardized manner. Three measurements will be obtained at each anatomical location, and the mean value will be recorded for analysis.
Measured: Participants receiving treatment will be evaluated at baseline (T0), at Month 1 (T1), and at Month 3 (T2).
Secondary outcomes (9)
Lateral femoral condyle cartilage thickness (mm)
All ultrasonographic measurements will be performed using a Clarius L7 HD3 linear high-frequency transducer (7.5-12 MHz) with the knee positioned in 90° flexion in a standardized manner. Three measurements will be obtained at each anatomical location, and the mean value will be recorded for analysis.
Measured: Participants receiving treatment will be evaluated at baseline (T0), at Month 1 (T1), and at Month 3 (T2).
Intercondylar area cartilage thickness (mm)
All ultrasonographic measurements will be performed using a Clarius L7 HD3 linear high-frequency transducer (7.5-12 MHz) with the knee positioned in 90° flexion in a standardized manner. Three measurements will be obtained at each anatomical location, and the mean value will be recorded for analysis.
Measured: Participants receiving treatment will be evaluated at baseline (T0), at Month 1 (T1), and at Month 3 (T2).
Ultrasound Femoral Cartilage Degeneration Grade
Evaluation will be performed with the symptomatic knee positioned in maximum flexion.
Cartilage degeneration will be classified as follows:
Grade 1: Blurred margins or partial loss of sharpness without thickness change Grade 2: Blurred margin space with partial loss of sharpness without thickness change Grade 3: Blurred margins with loss of clarity Grade 4: Poorly defined margins with a completely opaque band Grade 5: Evident thickness alteration Grade 6: Cartilage band cannot be visualized
Measured: Participants receiving treatment will be evaluated at baseline (T0), at Month 1 (T1), and at Month 3 (T2).
Synovial Hypertrophy Grade
Ultrasound assessment will be performed in accordance with the EULAR and Outcome Measures in Rheumatology Clinical Trials (OMERACT) guidelines using both longitudinal and axial views.
For evaluation of synovial hypertrophy, the suprapatellar, medial parapatellar, and lateral parapatellar recesses will be scanned with the knee positioned in 30° flexion.
Synovial hypertrophy will be graded as follows:
Grade 0: No synovial thickening Grade 1: Mild synovial thickening Grade 2: Moderate synovial thickening Grade 3: Severe synovial thickening
Measured: Participants receiving treatment will be evaluated at baseline (T0), at Month 1 (T1), and at Month 3 (T2).
Rectus femoris muscle thickness (cm)
Rectus femoris muscle thickness will be measured with the participant in the supine position and with the hip and knee in extension. The ultrasound transducer will be placed axially over the muscle. Measurements will be obtained at the junction between the lower one-third and upper two-thirds of the distance from the anterior superior iliac spine (ASIS) to the superior pole of the patella, which will serve as the anatomical reference point.
Measured: Participants receiving treatment will be evaluated at baseline (T0), at Month 1 (T1), and at Month 3 (T2).
Gluteus medius (GMed) muscle thickness (cm)
Participants will be positioned in side-lying with the left leg uppermost. The left hip region will be exposed, and a towel will be placed under the ankle to maintain a neutral alignment of the hip, knee, and ankle joints. To assess the gluteus medius muscle, the ultrasound transducer will be placed longitudinally on the lateral aspect of the hip, just superior to the greater trochanter, at the anterior one-quarter of the line connecting the anterior superior iliac spine (ASIS) and posterior superior iliac spine (PSIS).
Measured: Participants receiving treatment will be evaluated at baseline (T0), at Month 1 (T1), and at Month 3 (T2).
Adductor longus muscle thickness (cm)
Participants will be positioned in the supine position, with the thigh in abduction and external rotation and the knee flexed to 20-30°. The knee will be supported with a rolled towel. Measurements will be obtained at the junction between the upper one-third and lower two-thirds of the distance from the pubic symphysis to the medial femoral epicondyle, which will serve as the anatomical reference point.
Measured: Participants receiving treatment will be evaluated at baseline (T0), at Month 1 (T1), and at Month 3 (T2).
Visual Analog Scale (VAS)
The Visual Analog Scale is used to assess pain intensity. Participants will be asked to indicate the severity of their knee pain on a scale ranging from 0 (no pain) to 10 (worst imaginable pain) by selecting the point that best represents their pain level.
Measured: Participants receiving treatment will be evaluated at baseline (T0), at Month 1 (T1), and at Month 3 (T2).
WOMAC Osteoarthritis Index
The WOMAC Osteoarthritis Index consists of 24 items rated on a 5-point Likert scale. It includes three subscales: pain, stiffness, and physical function. The pain subscale contains 5 items and is scored from 0 to 20. The stiffness subscale includes 2 items and is scored from 0 to 8. The physical function subscale consists of 17 items and is scored from 0 to 68. Higher scores indicate greater pain, increased stiffness, and poorer functional status. The Turkish validity and reliability study of the WOMAC scale was conducted by Tüzün et al.
Measured: Participants receiving treatment will be evaluated at baseline (T0), at Month 1 (T1), and at Month 3 (T2).
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Jun 2026
- Study start20 Aug 2026 (estimated)
- Primary completion1 Apr 2027 (estimated)
- Study completion1 Jul 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (27)Papers the sponsor has linked to this study.
- Other trials for Osteo Arthritis of the KneeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 56 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Pamukkale University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, MERVE ARBAY, Kutahya Health Sciences University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07657481
- Sponsor's protocol ID
- PamukkaleU.ftr-MArbayCeltek-01
- Status last verified
- Jun 2026
- First submitted
- 14 Jun 2026
- Last updated
- 22 Jun 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Lee CL, Huang MH, Chai CY, Chen CH, Su JY, Tien YC. The validity of in vivo ultrasonographic grading of osteoarthritic femoral condylar cartilage: a comparison with in vitro ultrasonographic and histologic gradings. Osteoarthritis Cartilage. 2008 Mar;16(3):352-8. doi: 10.1016/j.joca.2007.07.013. Epub 2007 Oct 24.
PubMed 17920940Karalilova R, Kazakova M, Batalov A, Sarafian V. Correlation between protein YKL-40 and ultrasonographic findings in active knee osteoarthritis. Med Ultrason. 2018 Feb 4;1(1):57-63. doi: 10.11152/mu-1247.
PubMed 29400369Tuzun EH, Eker L, Aytar A, Daskapan A, Bayramoglu M. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthritis Cartilage. 2005 Jan;13(1):28-33. doi: 10.1016/j.joca.2004.10.010.
PubMed 15639634Manske RC, Wolfe C, Page P, Voight M. Diagnostic Musculoskeletal Ultrasound in the Evaluation of Adductor Longus Injuries: Implications for Rehabilitation Providers. Int J Sports Phys Ther. 2025 Nov 1;20(11):1670-1674. doi: 10.26603/001c.146209. eCollection 2025.
PubMed 41185658Whittaker JL, Emery CA. Sonographic measures of the gluteus medius, gluteus minimus, and vastus medialis muscles. J Orthop Sports Phys Ther. 2014 Aug;44(8):627-32. doi: 10.2519/jospt.2014.5315. Epub 2014 Jul 16.
PubMed 25029916Tillquist M, Kutsogiannis DJ, Wischmeyer PE, Kummerlen C, Leung R, Stollery D, Karvellas CJ, Preiser JC, Bird N, Kozar R, Heyland DK. Bedside ultrasound is a practical and reliable measurement tool for assessing quadriceps muscle layer thickness. JPEN J Parenter Enteral Nutr. 2014 Sep;38(7):886-90. doi: 10.1177/0148607113501327. Epub 2013 Aug 26.
PubMed 23980134KELLGREN JH, LAWRENCE JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957 Dec;16(4):494-502. doi: 10.1136/ard.16.4.494. No abstract available.
PubMed 13498604Bennell KL, Hunt MA, Wrigley TV, Hunter DJ, McManus FJ, Hodges PW, Li L, Hinman RS. Hip strengthening reduces symptoms but not knee load in people with medial knee osteoarthritis and varus malalignment: a randomised controlled trial. Osteoarthritis Cartilage. 2010 May;18(5):621-8. doi: 10.1016/j.joca.2010.01.010. Epub 2010 Feb 6.
PubMed 20175973Powers CM. The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. J Orthop Sports Phys Ther. 2010 Feb;40(2):42-51. doi: 10.2519/jospt.2010.3337.
PubMed 20118526Bennell KL, Wrigley TV, Hunt MA, Lim BW, Hinman RS. Update on the role of muscle in the genesis and management of knee osteoarthritis. Rheum Dis Clin North Am. 2013 Feb;39(1):145-76. doi: 10.1016/j.rdc.2012.11.003. Epub 2012 Nov 22.
PubMed 23312414Kean CO, Bennell KL, Wrigley TV, Hinman RS. Relationship between hip abductor strength and external hip and knee adduction moments in medial knee osteoarthritis. Clin Biomech (Bristol). 2015 Mar;30(3):226-30. doi: 10.1016/j.clinbiomech.2015.01.008. Epub 2015 Feb 3.
PubMed 25703964Yuenyongviwat V, Duangmanee S, Iamthanaporn K, Tuntarattanapong P, Hongnaparak T. Effect of hip abductor strengthening exercises in knee osteoarthritis: a randomized controlled trial. BMC Musculoskelet Disord. 2020 May 7;21(1):284. doi: 10.1186/s12891-020-03316-z.
PubMed 32380994Segal NA, Nevitt MC, Gross KD, Hietpas J, Glass NA, Lewis CE, Torner JC. The Multicenter Osteoarthritis Study: opportunities for rehabilitation research. PM R. 2013 Aug;5(8):647-54. doi: 10.1016/j.pmrj.2013.04.014.
PubMed 23953013Deasy M, Leahy E, Semciw AI. Hip Strength Deficits in People With Symptomatic Knee Osteoarthritis: A Systematic Review With Meta-analysis. J Orthop Sports Phys Ther. 2016 Aug;46(8):629-39. doi: 10.2519/jospt.2016.6618. Epub 2016 Jul 3.
PubMed 27374011Thomas DT, R S, Prabhakar AJ, Dineshbhai PV, Eapen C. Hip abductor strengthening in patients diagnosed with knee osteoarthritis - a systematic review and meta-analysis. BMC Musculoskelet Disord. 2022 Jun 29;23(1):622. doi: 10.1186/s12891-022-05557-6.
PubMed 35768802
Study at a glance
From the registry record, last updated by the sponsor on 22 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of the Effects of Two Different Home Exercise Programs on Femoral Cartilage Thickness and Clinical Parameters in Individuals With Knee Osteoarthritis: A Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07657481
- Acronym / sponsor ID
- PamukkaleU.ftr-MArbayCeltek-01
- Conditions
- Osteo Arthritis of the Knee
- Keywords
- knee osteoartritis, femoral cartilage thikness, quadriceps strengthening exercises, hip abductor and adductor strengthening exercises
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 56 participants (estimated)
- Lead sponsor
- Pamukkale UniversityUniversity, hospital or other
- Study start
- 20 Aug 2026 (estimated)
- Primary completion
- 1 Apr 2027 (estimated)
- Study completion
- 1 Jul 2027 (estimated)
- First posted
- 18 Jun 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Knee osteoarthritis (OA) is one of the most common joint disorders worldwide and is a leading cause of pain, limited mobility, and functional disability, particularly in the elderly population. According to 2020 data, approximately 654 million individuals aged 40 years and older are affected by knee OA worldwide, with a global prevalence of 22.9% in this age group. In our country as well, OA is reported as the second most common rheumatologic disease. The disease not only negatively affects individuals' quality of life but also creates a significant socioeconomic burden through work loss, hospital admissions, and the need for surgical interventions.
The pathogenesis of knee OA is a complex process involving articular cartilage degeneration, subchondral bone sclerosis, synovial tissue proliferation, and osteophyte formation. Once cartilage damage begins, its capacity for spontaneous healing is extremely limited; therefore, early interventions aimed at slowing or halting disease progression are of critical importance. In this context, non-pharmacological interventions, particularly exercise programs that may contribute to maintaining cartilage integrity, are strongly recommended as first-line treatment options in current clinical guidelines.
The beneficial effects of exercise therapy on pain and function in patients with knee OA are well documented. However, the structural effects of exercise on femoral cartilage thickness have been relatively less investigated. Tuna et al. evaluated femoral cartilage thickness using ultrasonography in 40 patients with knee OA following a 12-week quadriceps strengthening program and reported statistically significant increases in cartilage thickness in the medial condyle, lateral condyle, and intercondylar region at 3 months. This pioneering study suggests that muscle strengthening programs may have not only symptomatic but also structural benefits. Similarly, Bozan et al. reported a strong positive correlation between quadriceps muscle thickness (rectus femoris + vastus intermedius) and femoral cartilage thickness, supporting the idea that muscle loss parallels cartilage degeneration. However, these studies focused exclusively on the quadriceps muscle, and the effects of hip musculature on femoral cartilage thickness have not been investigated. Recent biomechanical studies indicate that hip abductor and adductor muscles play a critical role in knee joint loading patterns.
Hip abductor muscles provide pelvic stability during gait and directly influence knee adduction moments. Weakness of the gluteus medius leads to contralateral pelvic drop, increasing medial compartment loading on the ipsilateral knee and accelerating medial tibiofemoral cartilage wear. Indeed, Segal et al., using data from the Multicenter Osteoarthritis Study (MOST), demonstrated via MRI that greater hip abductor strength significantly reduces the risk of progression of medial patellofemoral and lateral tibiofemoral cartilage damage. On the other hand, hip adductor muscles are also thought to contribute to knee adduction moments by eccentrically controlling femoral varus motion; however, this relationship has been studied far less compared to quadriceps and abductors.
Systematic reviews and meta-analyses have shown that individuals with knee OA have up to 24% lower isometric hip abductor strength compared to healthy controls. Randomized controlled trials investigating combined hip and quadriceps strengthening programs have reported significant improvements in pain and function. However, none of these studies have used femoral cartilage thickness measured by ultrasonography as a primary outcome.
A review of the current literature reveals that although studies exist examining the effects of quadriceps strengthening on femoral cartilage thickness, no randomized controlled trial has compared hip abductor and adductor strengthening exercises with a quadriceps strengthening program, using ultrasonographic femoral cartilage thickness as the primary outcome measure. This study aims to address this gap. All interventions will be applied as non-invasive home exercise programs, and all measurements will be performed using ultrasonography. Baseline, 1-month, and 3-month assessments will also allow evaluation of the temporal effects of exercise on cartilage structure. The findings are expected to provide scientific evidence regarding the structural protective effects of hip exercises in knee OA rehabilitation and serve as pilot data for future large-scale multicenter studies.
The aim of this study is to compare patients with knee OA receiving quadriceps strengthening exercises alone with those receiving additional hip abductor/adductor strengthening exercises in terms of changes in femoral cartilage thickness, and to evaluate whether there is a correlation between femoral cartilage thickness and the thickness of the rectus femoris, gluteus medius,
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Quadriceps Plus Hip Strengthening Group | Experimental | Other: Quadriceps Plus Hip Strengthening ExercisesFor 3 months, 3 days per week, participants will perform quadriceps strengthening exercises combined with hip abductor and adductor strengthening exercises. In addition to all exercises included in the Quadriceps Strengthening Group, participants will perform: Hip abduction (side-lying position with ankle weights) Clamshell exercise (for gluteus medius activation) Hip adduction (supine position with isometric contraction using a pillow) Side-lying hip abduction with a resistance band |
| Quadriceps Strengthening Group | Active comparator | Other: Quadriceps Strengthening ExercisesFor 3 months, 3 days per week, participants will perform a quadriceps strengthening exercise program only. The program will include: Knee extension (in a seated position, with and without resistance) Terminal knee extension Straight leg raise Mini squat (0-30° knee flexion) |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Age ≥18 years
- Diagnosis of knee osteoarthritis according to ACR criteria, Kellgren-Lawrence grade 2-3
- Knee pain for at least 3 months
- Having the physical capacity to perform a home exercise program
- Willingness to provide written informed consent
Key exclusion criteria (8 listed)
- History of knee, hip, or spine surgery
- Active inflammatory arthritis (e.g., rheumatoid arthritis, gout, psoriatic arthritis)
- Intra-articular injection within the last 3 months
- Neurological or neuromuscular disorders
- Body mass index (BMI) > 40 kg/m²
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Quadriceps Plus Hip Strengthening Exercisesquadriceps strengthening exercises combined with hip abductor and adductor strengthening exercises | Other | Quadriceps Plus Hip Strengthening Group |
| Quadriceps Strengthening Exercisesquadriceps strengthening exercise program | Other | Quadriceps Strengthening Group |
Primary outcome
Medial femoral condyle cartilage thickness (mm)
Time frame: Participants receiving treatment will be evaluated at baseline (T0), at Month 1 (T1), and at Month 3 (T2).
All ultrasonographic measurements will be performed using a Clarius L7 HD3 linear high-frequency transducer (7.5-12 MHz) with the knee positioned in 90° flexion in a standardized manner. Three measurements will be obtained at each anatomical location, and the mean value will be recorded for analysis.
9 secondary outcomes
Lateral femoral condyle cartilage thickness (mm)
Time frame: Participants receiving treatment will be evaluated at baseline (T0), at Month 1 (T1), and at Month 3 (T2).
Intercondylar area cartilage thickness (mm)
Time frame: Participants receiving treatment will be evaluated at baseline (T0), at Month 1 (T1), and at Month 3 (T2).
Ultrasound Femoral Cartilage Degeneration Grade
Time frame: Participants receiving treatment will be evaluated at baseline (T0), at Month 1 (T1), and at Month 3 (T2).
Synovial Hypertrophy Grade
Time frame: Participants receiving treatment will be evaluated at baseline (T0), at Month 1 (T1), and at Month 3 (T2).
Rectus femoris muscle thickness (cm)
Time frame: Participants receiving treatment will be evaluated at baseline (T0), at Month 1 (T1), and at Month 3 (T2).
Gluteus medius (GMed) muscle thickness (cm)
Time frame: Participants receiving treatment will be evaluated at baseline (T0), at Month 1 (T1), and at Month 3 (T2).
Adductor longus muscle thickness (cm)
Time frame: Participants receiving treatment will be evaluated at baseline (T0), at Month 1 (T1), and at Month 3 (T2).
Visual Analog Scale (VAS)
Time frame: Participants receiving treatment will be evaluated at baseline (T0), at Month 1 (T1), and at Month 3 (T2).
WOMAC Osteoarthritis Index
Time frame: Participants receiving treatment will be evaluated at baseline (T0), at Month 1 (T1), and at Month 3 (T2).
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Jun 2026.
- Results publication: PubMed 17920940Lee CL, Huang MH, Chai CY, Chen CH, Su JY, Tien YC. The validity of in vivo ultrasonographic grading of osteoarthritic femoral condylar cartilage: a comparison with in vitro ultrasonographic and histologic gradings. Osteoarthritis Cartilage. 2008 Mar;16(3):352-8. doi: 10.1016/j.joca.2007.07.013. Epub 2007 Oct 24.
- Results publication: PubMed 29400369Karalilova R, Kazakova M, Batalov A, Sarafian V. Correlation between protein YKL-40 and ultrasonographic findings in active knee osteoarthritis. Med Ultrason. 2018 Feb 4;1(1):57-63. doi: 10.11152/mu-1247.
- Results publication: PubMed 15639634Tuzun EH, Eker L, Aytar A, Daskapan A, Bayramoglu M. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthritis Cartilage. 2005 Jan;13(1):28-33. doi: 10.1016/j.joca.2004.10.010.
- Results publication: PubMed 41185658Manske RC, Wolfe C, Page P, Voight M. Diagnostic Musculoskeletal Ultrasound in the Evaluation of Adductor Longus Injuries: Implications for Rehabilitation Providers. Int J Sports Phys Ther. 2025 Nov 1;20(11):1670-1674. doi: 10.26603/001c.146209. eCollection 2025.
- Results publication: PubMed 25029916Whittaker JL, Emery CA. Sonographic measures of the gluteus medius, gluteus minimus, and vastus medialis muscles. J Orthop Sports Phys Ther. 2014 Aug;44(8):627-32. doi: 10.2519/jospt.2014.5315. Epub 2014 Jul 16.
- Results publication: PubMed 23980134Tillquist M, Kutsogiannis DJ, Wischmeyer PE, Kummerlen C, Leung R, Stollery D, Karvellas CJ, Preiser JC, Bird N, Kozar R, Heyland DK. Bedside ultrasound is a practical and reliable measurement tool for assessing quadriceps muscle layer thickness. JPEN J Parenter Enteral Nutr. 2014 Sep;38(7):886-90. doi: 10.1177/0148607113501327. Epub 2013 Aug 26.
- Results publication: PubMed 13498604KELLGREN JH, LAWRENCE JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957 Dec;16(4):494-502. doi: 10.1136/ard.16.4.494. No abstract available.
- Results publication: PubMed 20175973Bennell KL, Hunt MA, Wrigley TV, Hunter DJ, McManus FJ, Hodges PW, Li L, Hinman RS. Hip strengthening reduces symptoms but not knee load in people with medial knee osteoarthritis and varus malalignment: a randomised controlled trial. Osteoarthritis Cartilage. 2010 May;18(5):621-8. doi: 10.1016/j.joca.2010.01.010. Epub 2010 Feb 6.
- Results publication: PubMed 20118526Powers CM. The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. J Orthop Sports Phys Ther. 2010 Feb;40(2):42-51. doi: 10.2519/jospt.2010.3337.
- Results publication: PubMed 23312414Bennell KL, Wrigley TV, Hunt MA, Lim BW, Hinman RS. Update on the role of muscle in the genesis and management of knee osteoarthritis. Rheum Dis Clin North Am. 2013 Feb;39(1):145-76. doi: 10.1016/j.rdc.2012.11.003. Epub 2012 Nov 22.
- Results publication: PubMed 25703964Kean CO, Bennell KL, Wrigley TV, Hinman RS. Relationship between hip abductor strength and external hip and knee adduction moments in medial knee osteoarthritis. Clin Biomech (Bristol). 2015 Mar;30(3):226-30. doi: 10.1016/j.clinbiomech.2015.01.008. Epub 2015 Feb 3.
- Results publication: PubMed 32380994Yuenyongviwat V, Duangmanee S, Iamthanaporn K, Tuntarattanapong P, Hongnaparak T. Effect of hip abductor strengthening exercises in knee osteoarthritis: a randomized controlled trial. BMC Musculoskelet Disord. 2020 May 7;21(1):284. doi: 10.1186/s12891-020-03316-z.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Quadriceps Plus Hip Strengthening Exercises and Quadriceps Strengthening Exercises in people with Osteo Arthritis of the Knee, run by Pamukkale University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 22 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Merve Arbay Celtek (• +905343371877, arbaymerve@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Medial femoral condyle cartilage thickness (mm) (time frame: Participants receiving treatment will be evaluated at baseline (T0), at Month 1 (T1), and at Month 3 (T2).). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07657481, which also lists 27 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Jun 2026.