Aerobic vs Neuromuscular Exercise for Knee OA

Inclusion Criteria: * Age ≥18- years * Diagnosis of tibiofemoral knee OA according to the American College of Rheumatology criteria * Radiographically confirmed diagnosis of tibiofemoral OA based on radiographs not older than 6 months. * Average knee pain level ≥ 4 (0=No pain and 10=Worst pain) over the past week (7 days) * At least one of following risk factors for development of cardiovascular disease: * Body mass index ≥ 30 kg/m2 * Hypertension (or in treatment of): Systolic ≥ 135 and/or diastolic ≥ 85 mm Hg * Elevated HbA1c (or in treatment of): ≥ 130.7 mg/dL (44 mmol/mol) * Elevated Triglycerides (or in treatment of): ≥ 150 mg/dL (1.7 mmol/L) * Elevated Cholesterol (or in treatment of) (Low density lipides, LDL): LDL ≥ 54 mg/dL (3.0 mmol/L) Exclusion Criteria: * Contraindication to exercise (e.g., resting systolic blood pressure \> 200 or diastolic blood pressure \> 115, acute or reoccurring chest pain) * Unstable body weight the last 3 months (gain/loss outside +/- 5 kg) * Planned weight loss (non-pharmacological, pharmacological, and surgical) during study participation * Known current cancer * Major cardiovascular event within the last 5 years * Insulin dependent type 1 or type 2 diabetes * Psoriatic, rheumatoid, or gouty arthritis disease * Generalized pain syndromes such as fibromyalgia * Lumbar or cervical nerve root compression syndromes * Scheduled surgery during study participation * Treatment with biological medication * Impairments that prevent performance in high intensity aerobic exercise * Current or planned participation in other health research intervention studies * Pregnant/considering pregnancy * Any other condition or impairment that, in the opinion of the investigator, makes a potential participant unsuitable for participation or which obstruct participation, such as a large knee joint effusion, uncontrolled diabetes/hypertension, psychiatric or cognitive disorders, language barriers, or opiate dependency.