Results from a pilot study showed that 4 weeks of strength training involving the hip abductor muscles (such as the tensor fasciae latae muscle, which spans both the hip and knee joints) can decrease the external knee adduction.
moment by 9% and greatly reduce knee pain. Although this study provided some encouraging results for this type of muscle strengthening, it lacked a control group and included only six patients.

A randomized, controlled trial with a much larger sample size (89 participants, of which 76 completed the trial, were randomly allocated to either hip strengthening or the control group) failed to show any effect of hip abductor and adductor muscle strengthening on the knee adduction moment, although it was effective for knee pain relief.

Taking into account the rationale for medial compartment unloading, the lateral hamstrings and hip abductor muscles of patients with knee arthritis should be considered appropriate targets for knee strengthening programs, although further studies are required to confirm the efficacy of this approach.

Quadriceps muscle strength training has conventionally been advocated for the treatment and/or management of knee osteoarthritis; however, no clear rationale exists as to how strengthening this specific muscle group would help to unload the medial compartment of the knee.

A 12-week quadriceps strengthening program in patients with arthritis failed to influence the external knee adduction moment and only relieved knee pain in patients with a fairly neutral knee alignment. The intervention had no effect on pain in patients with a valgus knee alignment