<i>“I Was Told I Needed Both Knees Surgically Replaced, but I Walked the Camino Trail Instead.”</i> A Case Report of A 66-year-old Male with Knee Osteoarthritis

PN had long-term symptomatic knee osteoarthritis and was advised that bilateral arthroplasty was required. He chose to avoid surgery, instead participating in a clinical trial evaluating the effect of embedding pain science education (PSE) into an individualized, graded exercise program (EPIPHA-KNEE trial).</p> <p>The intervention involved four weekly in-person sessions, five telehealth sessions (weeks 5–8, 12), and two top-up in-person sessions (weeks 21, 39).

A key intervention component was activity-related goal setting, with cognitive reconceptualization and activity progression underpinned by PSE. PN set an “aspirational goal” – to walk the Camino de Santiago Trail. Clinical outcomes and device-measured activity levels were assessed at baseline, 8, 26 and 52 weeks.</p> <p>Relative to baseline, PN experienced improvements in knee pain (83% reduction), function (71% improvement), and activity levels (50% increase) at 52 weeks with cessation of pain medication use and resolution of knee swelling and night pain.