A structured 10–14 week programme combining viscosupplementation, physiotherapy, and measurable milestones — built for Kellgren-Lawrence II–III osteoarthritis.
Knee osteoarthritis is a slow disease with fast flare-ups. Patients usually reach us after the third or fourth flare — a bad week after a long drive to Tagaytay, a swollen knee after the first monsoon front, the morning stiffness that now takes until lunchtime to lift. At that point, most have had an X-ray, been told they have "arthritis," and been handed a course of NSAIDs. That is information, not a plan.
The Osteoarthritis Program exists because the evidence is unambiguous: multi-modal conservative management outperforms any single intervention. OARSI 2019 and NICE 2022 guidelines both list exercise and weight management as first-line — not optional. Viscosupplementation and targeted injections are valuable within that context. Our 12-session, 10–14 week programme delivers all of it as a single pathway, with outcome measurement at entry, week 6, and exit using the WOMAC score and VAS pain scale.
The ideal candidate has Kellgren-Lawrence grade II or III knee osteoarthritis on recent X-rays, a WOMAC score above 30, and is not yet a surgical candidate (or is actively avoiding TKR). BMI under 35. No active infection, no uncontrolled diabetes, no recent intra-articular steroid in the past 3 months. We screen for all of this at the intake consultation — if the joint is already KL IV with bone-on-bone contact and mechanical locking, we are honest that the programme is unlikely to change the trajectory and arthroplasty counselling is the better conversation.
Programmes beat packages. We measure on day one and on day ninety — and we change the plan if the numbers don't move. — Dr. Miguel Aguinaldo
The programme is priced as a bundle because the components genuinely belong together. If you want to build the same path à la carte, you can combine an initial consultation, three hyaluronic acid injections, and eight physiotherapy sessions — the bundle saves roughly ₱3,200. For background reading on how OA actually progresses and what the imaging means, this primer on Kellgren-Lawrence grading is worth fifteen minutes before your intake.
Week 0: 45-minute consultation, X-ray review, Kellgren-Lawrence grading, WOMAC and VAS baseline, goal-setting, home-programme handout.
Weeks 1, 2, 3: ultrasound-guided Orthovisc/Synvisc into the knee. 48-hour activity taper after each shot, rehab resumes on day 3.
Four PT sessions: isometric quadriceps, closed-chain squats to pain tolerance, gait retraining, load-management education.
Week 6: repeat WOMAC, VAS, ROM, and single-leg sit-to-stand. Programme adjusted if scores haven't moved ≥15%.
Four PT sessions: progressive resistance, step-down control, stair and slope tolerance, return to weekend walking.
Week 12: final WOMAC/VAS, written maintenance programme, 3-month and 12-month review booked. Re-injection triggers defined.
It can delay it meaningfully for many KL II–III knees — often by 3–7 years in the literature — but it is not a guarantee. If cartilage is already bone-on-bone (KL IV), the programme buys quality-of-life time rather than avoiding surgery. We are transparent about this at intake.
Partial. Most HMOs cover the physiotherapy component and the consultation, and some cover HA injections with a rider. We itemise the receipt so your HMO reimbursement is straightforward. Kaiser and EastWest typically reimburse the most on HA.
We know by the week 6 review. If WOMAC has moved less than 15%, we discuss switching to PRP (see our injections page), adding a brief corticosteroid cycle for flare control, or — if the joint is structurally worse than first thought — pivoting the conversation to surgical consultation.
Yes. This is designed around working Ayala and BGC professionals. Rehab is bookable until 19:00 weekdays and Saturday mornings. The 48-hour taper after each HA injection is the only real disruption — we schedule those on Fridays by default.
Every 1 kg lost reduces knee joint load by roughly 4 kg at heel strike. We do not run the weight management piece in-house but refer to two dietitian partners in the Ayala area we trust. If BMI is over 30, we flag this in the plan and expect to revisit at review.
Three numbers, measured on day 0, week 6, and week 12: WOMAC total score, VAS pain on activity, and 30-second sit-to-stand count. A clinically meaningful result is a ≥20% improvement on two of three. For a deeper look at how we track progress, read this recovery guide on outcome measures.
Bring your last knee X-ray. We grade the joint, agree on the goals, and book the full 10–14 weeks at intake.
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