The Role of Myofascial Release Techniques as an Adjunct to Other Therapies in Knee Osteoarthritis: A Systematic Review.

Background and Aim: Myofascial dysfunctions have been recognized as a pain-causing component in knee osteoarthritis (KOA). Recently, clinicians have focused on various therapeutic techniques targeting fascia. The myofascial release technique (MRT) aimed to address fascial restrictions and myofascial trigger points to improve range of motion (ROM) and muscle function before rehabilitation or physical activity. This systematic review aimed to evaluate the effectiveness and safety of MRT in individuals with KOA, to provide an evidence-based foundation for their clinical application. Methods: PRISMA guidelines were performed for this review. Randomized or non-randomized controlled trials were systematically collected from PubMed, Scopus, Web of Science, Science Direct, Google Scholar, and ProQuest from their inception until May 2025. The methodological quality of the articles was assessed using the PEDro checklist. Results: Of the 789 records identified, 12 were deemed relevant. The studies exhibited a mean quality score of 4-5 (acceptable) in six studies, a mean quality score of 3 (poor) in one study, and a mean quality score of 6-8 in five studies. The duration of MRT treatment ranged from 3 to 12 sessions, with most studies administering 12 sessions over a period of 2-6 weeks. The outcome measures included pain levels, knee flexion ROM, functional disability, muscle strength, quality of life, knee alignment, and dynamic knee valgus. Five trials compared MRT combined with conventional therapies to a conventional physiotherapy group alone, two trials compared MRT combined with conventional therapies to an MRT group alone, and five trials compared MRT to other therapeutic techniques. Conclusion: MRT, when used as an adjunct to conventional therapies or corrective exercises, was found to be more effective in reducing pain, enhancing functional ability, and improving knee range of motion in individuals with KOA. However, MRT alone did not demonstrate consistent superiority over other manual therapy techniques. Due to the concurrent use of multiple interventions in most studies, the specific contribution of MRT remains uncertain. Thus, MRT may be considered a potentially beneficial complementary therapy, but further high-quality studies are needed to establish its standalone efficacy.