Osteoarthritis and rheumatoid arthritis treatment

The images below illustrate joint space narrowing in a 43 year old female patient with a long standing history of rheumatoid arthritis. The image on the lower left is a skyline view of her patellofemoral joint (the knee cap looking from above with the knee bent). The patella is being pulled laterally which is causing considerable pain. the physiotherapist is working to improve the muscle control on the inside of the knee (vastus medialis oblique) and stretch structures laterally (the ITB and gluteals).