Patient case (clinical description): A 47-year-old woman comes to the office complaining of pain in the calf and knee when she bends down. The pain limits her activity. Her medical history is significant for osteoarthritis, for which she uses nonsteroidal anti-inflammatory drugs (NSAIDs) for the past two years. She is living with her husband and has 3 children. She doesn't smoke but drinks alcohol occasionally. Her vital signs are normal. On physical examination, there is a small effusion in the right knee. The effusion grew a little larger and she developed a tender swelling in the popliteal fossa and calf. Both the pain and swelling worsened as she bent and straightened her knee.

Patient's own account: I'm a 47-year-old woman, married with 3 kids. I don't smoke and I drink occasionally. I went to the doctor because of pain in my calf and knee when I was bending down. This has been limiting my daily activities. I have been diagnosed with osteoarthritis for which I have taken anti-inflammatory drugs for the past 2 years. The doctor saw a small fluid buildup in my right knee. This buildup became a bit bigger and I have a swollen calf. The pain is worse when I bend and straighten my knee.

Clinical trial: The Effect of AposTherapy on Knee Pain

Eligibility criteria:
Inclusion Criteria:

          -  Patients suffering from symptomatic knee OA (uni/bi lateral) for at least six months,
             fulfilling the ACR clinical criteria for OA of the knee, and having radiographically
             assessed OA of the knee according to the Kellgren and Lawrence scale.

          -  Patients with VAS pain score of ≥3cm (measured at baseline).

          -  Males and females between the ages of 40-75.

          -  17<BMI<40

          -  Ambulatory and active patients that can participate in a rehabilitation program that
             includes daily walking

          -  Stable medical regimen (no recent changes to the pain medication within a month)

          -  Able to walk at least 50 meters and scored positive on the STEADI test

          -  Able to understand, read and sign the informed consent form

          -  English or Spanish speaking

        Exclusion Criteria:

          -  Patients suffering from acute septic arthritis.

          -  Patients suffering from inflammatory joint disease such as rheumatoid arthritis.

          -  Patients with diagnosis of avascular necrosis of the knee.

          -  Patients with diagnosis of neuromuscular disease.

          -  Patients with more than 3 falls in the last 12 months, OR any fall with an injury in
             the last 12 months.

          -  Patients exhibiting a lack of physical or mental ability to perform or comply with the
             study procedure.

          -  Patients with a history of pathological osteoporotic fracture

          -  Patients with referred pain in the knees from back or hip joint symptoms.

          -  Patients with severe back pain, ≥ 4 cm in visual analogue scale (0-10) [1] or
             radiating leg pain

          -  Patients with generalized body pain (both upper and lower extremities, such as
             fibromyalgia

          -  No major surgery to the affected limb and contralateral limb (e.g. no joint
             replacements or surgical fracture repair)

          -  No major cardiovascular comorbidities (able to enroll in an active exercise program)

          -  Patient started on lipid lowering medication in last 3 months

          -  Any change in blood pressure medications

          -  No recent physical therapy (no more recent than 6 months) on the affected limb

          -  No active heart disease (ischemia or heart failure admissions within 6 months) and no
             active COPD (exacerbation within 6 months)

          -  No active malignancies on ongoing treatment

          -  Patient with neurological gait pattern

          -  Patient requiring assistive device during gait analysis.
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 40 Years old.
Subject must be at most 75 Years

Eligibility (NLI label): Entailment