21 randomized control studies examining the use of strength training, exercise therapy, and exercise therapy with passive, manual mobilization in adult patients with knee osteoarthritis were examined in this meta-analysis. This study was undertaken to determine the comparative efficacy of these three treatment methods. The results form this analysis suggest that pain outcomes can be reduced with the addition of manual mobilization to exercise therapy. However, there were no differences in physical function measures between the three groups. Further research is required to determine the long term effects of physiotherapy with manual mobilization.