Background and objectives: Knee osteoarthritis (KOA) is a degenerative joint disorder often associated with altered gait mechanics. This systematic review aims to evaluate the effect of rehabilitation treatment on walking, with a focus on gait speed. Material and methods: A systematic search was conducted in PubMed, Scopus, Web of Science, Cochrane, and PEDro databases, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. Randomised controlled trials published in English between 2015 and 2025, involving patients with KOA undergoing rehabilitation and using computerised gait measurements, including 3D motion capture, force plates, and instrumented treadmills, were included. A meta-analysis was conducted on the selected studies assessing gait speed, with the risk of bias being evaluated using the Cochrane Risk of Bias 2 tool for RCTs. Results: Out of 2143 articles, 7 studies met the inclusion criteria. These studies showed increased gait speed in patients with KOA following exercise therapy, various walking training programmes, massage, or dietary interventions. The meta-analysis revealed a standardised mean difference (SMD) of 1.807, with a 95% confidence interval (CI) of [1.637, 1.977] (p < 0.001). The interventions were associated with improvements in walking parameters and quality of life, as well as reductions in pain and fall risk. Substantial heterogeneity was noted, likely due to variations in intervention types and study populations. Conclusions: The results suggest an overall improvement in gait speed in the intervention groups compared to the control groups. However, only a limited number of studies have investigated the effects of physiotherapy, bath therapy, or mud therapy on gait mechanics in patients with KOA.

Background and Objectives: Musculoskeletal ultrasound (MSUS) is increasingly used to assess structural changes in knee osteoarthritis (KOA), although measurement reproducibility may vary with examination protocol and operator experience. This pilot study aimed to evaluate intra- and inter-observer reliability for assessing cartilage thickness, osteophyte dimensions and meniscal displacement in supine and weight-bearing conditions in patients with KOA. Material and Methods: This prospective reliability study included patients with KOA stages 2–3 on the Kellgren–Lawrence (K-L) scale. Ultrasound (US) evaluation of cartilage thickness and osteophytes was performed in the supine position, while medial and lateral meniscal extrusion was additionally assessed in bipedal and single-leg conditions using a standardized protocol. Intra- and inter-reproducibility were evaluated through the intraclass correlation coefficient (ICC), agreement analysis and kappa statistics. The analysis was performed using Microsoft Excel (version 2019) and IBM SPSS version 26 software. Results: Both inter-reliability and intra-reliability were evaluated, with intra-rater agreement being constantly higher than inter-rater agreement. From the inter-rater reliability, ICC values ranged from 0.48 to 0.88 for quantitative ultrasound measurements, whereas osteophyte assessment showed Cohen’s k values ranging from 0.71 to 0.86, indicating substantial to almost perfect agreement. Both evaluators identified a higher number of knees with medial meniscal extrusion > 3 mm under weight-bearing conditions than in the supine position. Conclusions: Standardized US evaluation demonstrated at least good reproducibility for structural abnormalities in KOA. Medial and lateral meniscal displacement increased under loading conditions, highlighting the added value of dynamic weight-bearing assessment. However, the clinical significance of load-dependent meniscal extrusion requires further investigation.