Treatment for Hand on Knee Gait

Primary Treatment Options

The American College of Rheumatology recommends tibiofemoral knee braces for patients with hand on knee gait due to knee osteoarthritis, as they provide significant improvement in ambulation, joint stability, and pain relief 1
Patellofemoral braces are conditionally recommended for patients with patellofemoral knee OA contributing to the hand on knee gait pattern, according to the American College of Rheumatology 2
Kinesiotaping is conditionally recommended as it permits range of motion while providing some stability, as suggested by the American College of Rheumatology 3
Strengthening exercises, focusing on quadriceps and hamstring strengthening, are recommended to improve knee stability during gait, with a moderate strength of evidence 4
Aerobic and aquatic exercises are strongly recommended to improve overall function and reduce pain that may be contributing to compensatory gait patterns, with a high strength of evidence 5

Walking aids are conditionally recommended to reduce load on the affected knee and improve stability, potentially eliminating the need for hand-on-knee support, according to the American College of Rheumatology 1
Evaluation for assistive devices is recommended, as all patients should be evaluated by a healthcare professional for their ability to perform activities of daily living and receive appropriate assistive devices, with a moderate strength of evidence 6

Topical NSAIDs are conditionally recommended, especially for patients aged ≥75 years, with a low strength of evidence 6
Oral NSAIDs are conditionally recommended for younger patients without contraindications, with a moderate strength of evidence 6
Thermal interventions are conditionally recommended for pain relief, including locally applied heat or cold, with a low strength of evidence 3
Instruction in joint protection is conditionally recommended to reduce stress on affected joints, with a moderate strength of evidence 6
Weight reduction is strongly recommended for overweight patients to reduce knee joint loading, with a high strength of evidence 7

Initial assessment should include evaluation of severity of knee instability and quadriceps weakness, with a moderate strength of evidence 1
First-line interventions should include prescription of appropriate knee brace and initiation of exercise program focusing on quadriceps strengthening, with a moderate strength of evidence 1, 4
Adjunctive therapies may include thermal modalities for pain relief and consideration of appropriate pain medications, with a low strength of evidence 3, 6