Lived Experiences and Perceptions of People with Knee Osteoarthritis in Saudi Arabia:

Objectives: To explore how people with knee osteoarthritis (OA) in Kingdom of Saudi Arabia (KSA) perceive and live with their condition, how they self-manage symptoms, and how they experience physiotherapy and rehabilitation services. Methods: A descriptive qualitative study was conducted using semi-structured interviews. Interviews were undertaken with individuals with knee OA who are aged ≥45 years. Interviews were audio-recorded, transcribed verbatim, de-identified and analyzed using reflexive thematic analysis with investigator triangulation. Results: Twenty-seven (19 females) participants aged 45-74 years (mean = 61) from different regions of KSA shared lived experiences of knee OA. Four themes describing participants' experiences with knee OA were identified from interview data: i) living with the progression of knee OA: from onset to functional limitation and psychological consequences, ii) traditional remedies and medical treatments were used to manage knee OA symptoms, iii) engagement with physiotherapy: referral, adherence, perceived outcomes, and therapeutic relationships with therapist, iv) and accessibility challenges, service limitations, and patient suggestions for improvement. Conclusion: Study findings indicate that people with knee OA in KSA live with chronic pain, functional limitations, and fluctuating engagement across traditional, medical, and physiotherapy treatments. Providing culturally sensitive education, more flexible physiotherapy options, and service improvements aligned with patients' suggestions may support better engagement and outcomes.