Optimal management of knee osteoarthritis (KOA) should include, where possible, modification of risk factors through targeted interventions. The objectives of the present narrative review were to identify, summarize, and cluster all the potentially modifiable risk factors that influence the course of KOA, and discuss their susceptibility to alteration via personal, clinical, and public strategy. For this purpose, Pubmed and Scopus databases were queried using the terms “knee osteoarthritis”, “risk factors” and “improvement”. Six main categories of modifiable risk factors were identified: (1) obesity and overweight, (2) comorbidity, (3) occupational factors, (4) physical activity, (5) biomechanical factors, (6) dietary exposures. In the era of age- and obesity-related diseases, the combined effects of local and systemic risk factors should be managed by combined measures. Femoral muscle-strengthening physical activities, complemented with proper diet, weight loss, vocational rehabilitation, management of comorbidities (especially diabetes and depression), and biomechanical support may add up to the holistic therapeutic approach towards the patient with KOA. An individual risk factor modification program should be developed in accordance with patient preferences and habits, workplace, medical history, and overall health condition. Due to its great impact on a wide range of functions and tissues, interventions on modifiable risk factors improve not only the symptoms of KOA but also affect the osteoarthritic joint as a whole.

Tsvetoslav Georgiev

Alexander Krasimirov Angelov

Rheumatology International

RHEUMATOLOGY INTERNATIONAL 是一份反映世界范围内各种风湿性疾病研究、诊断和治疗进展的独立期刊。它旨在为风湿病学领域的研究人员和临床医生提供服务。风湿病学国际将涵盖临床研究以及风湿病管理的所有现代趋势。将特别强调与风湿病相关的公共卫生问题，将风湿病研究应用于临床实践，风湿病流行病学，风湿病诊断测试，风湿病患者报告结果（PROS）和风湿病教育证据。对这些主题的贡献将以原始出版物、简短的交流、社论和评论的形式出现。欢迎“致编辑的信”作为讨论的补充。不鼓励提交基础科学研究，包括体外或动物研究，因为我们只会从流行病学或临床角度审查对人类的研究。没有对文献（基于案例的评论）进行适当审查的病例报告将不会发表。将尽一切努力确保出版速度，同时保持高标准的内容和生产。提交出版的手稿必须包含声明，说明所有人体研究都已通过相应的伦理委员会审查，因此已按照符合 1964 年赫尔辛基宣言的适当版本中规定的道德标准。还应在正文中明确说明所有人员在纳入研究之前均已签署知情同意书。应省略可能披露研究对象身份的细节。

Rheumatology International is an independent journal that reflects the research, diagnosis, and treatment advancements of rheumatic diseases worldwide. It serves researchers and clinicians in the field of rheumatology, covering modern trends in clinical research and rheumatic disease management. The journal places special emphasis on public health issues related to rheumatic diseases and aims to apply rheumatology research to clinical practice, including epidemiology, diagnostic testing, patient-reported outcomes (PROS), and evidence for rheumatology education. Contributions on these topics will be published in the form of original articles, brief communications, editorials, and reviews, and letters to the editor are welcomed as supplementary discussions. The journal does not encourage the submission of basic scientific research, including in vitro or animal studies, focusing instead on human studies from an epidemiological or clinical perspective. Case reports that have not undergone appropriate review will not be published. We strive to ensure a rapid publication process while maintaining high standards of content and production quality. All submitted manuscripts must include a statement indicating that all human research has been reviewed by the appropriate ethics committee and complies with the ethical standards set forth in the latest version of the Declaration of Helsinki from 1964. Furthermore, the main text should clearly state that all participants signed informed consent prior to inclusion in the study, and details that may disclose the identity of research subjects should be omitted.

《Rheumatology International》是一本独立期刊，旨在反映全球范围内风湿性疾病的研究、诊断和治疗进展。它为风湿病学领域的研究人员和临床医生提供服务，涵盖临床研究及风湿病管理的现代趋势。期刊特别强调与风湿病相关的公共卫生问题，致力于将风湿病研究应用于临床实践，包括流行病学、诊断测试、患者报告结果（PROS）和风湿病教育的证据。对这些主题的贡献将以原始研究、简短交流、社论和评论的形式发表，同时欢迎“致编辑的信”作为讨论的补充。期刊不鼓励基础科学研究的提交，包括体外或动物研究，主要关注流行病学或临床角度的人类研究。未经过适当审查的病例报告将不予发表。我们将尽力确保出版速度，同时保持高标准的内容和生产质量。所有提交的手稿必须包含声明，说明所有人体研究已通过相应的伦理委员会审查，并符合1964年赫尔辛基宣言的伦理标准。此外，正文中应明确说明所有参与者在纳入研究前已签署知情同意书，并省略可能披露研究对象身份的细节。

Category	Quartile
医学	3
医学, 风湿病学	4

Modifiable risk factors in knee osteoarthritis: treatment implications

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