Understanding Osteoarthritis of the Knee: Stages, Diagnosis, and Treatment Options

Osteoarthritis of the knee is a common form of arthritis that can affect various joints in the body, including the knee. The knee is particularly susceptible to OA, as it is a weight-bearing joint that experiences significant stress and pressure over time. In this article, we will discuss the stages of OA of the knee, how it is diagnosed, and the available treatment options.

Stages of OA of the knee

OA of the knee is a progressive condition that develops over several years. Doctors often use stages to describe the progression of the condition. The Kellgren-Lawrence (KL) classification is one system used to describe OA of the knee’s stages, but there are other grading systems.

The stages below follow the KL classification, based on a series of X-ray images of OA of the knee.

Stage 1: Minor

In the early stages of Osteoarthritis of the knee, a person may not experience any symptoms. An X-ray may not reveal any damage, but bony growths of bone called osteophytes can be an early sign of OA. Other changes in the joint at this stage can include slight damage to the cartilage and narrowing of the space between the bones in the joint. At this stage, a person is unlikely to experience discomfort or pain. The joint will appear healthy on an X-ray.

Stage 2: Mild

At this stage, an X-ray will possibly show narrowing of the space in the joint and bone spurs. A person may start to notice stiffness and joint pain, especially after resting for a while. The area where the bones and tissues meet will start to harden, and a thin layer of bone will also develop beneath the cartilage in the joints. There may be some minor damage, but the bones are not rubbing or scraping against each other. Synovial fluid is present, and it helps reduce friction, supporting the movement of the knee.

Stage 3: Moderate

At this stage, an X-ray will show a clear narrowing of the joint space, some development of bone spurs, and some damage to cartilage and other tissue. A possible deformity at the ends of the bones may also be visible. A person may notice pain and discomfort during daily activities, such as running, walking, kneeling, and bending. There may be early signs of joint inflammation, swelling, and fluid buildup around the joint due to synovitis, which people sometimes call water on the knee. As Osteoarthritis of the knee progresses, the cartilage will continue to thin and break down. The bones will respond by thickening and forming bony outward growths.

Stage 4: Severe

At this stage, an X-ray will show a severe narrowing of the joint space, as a result of which the bones meet and rub together. There will be a significant development of bone spurs, and the cartilage may have become fully or almost fully eroded. A definite deformity at the ends of the bones may also be visible. A person may experience stiffness in the joint, constant inflammation, less fluid around the joint, and significant pain and discomfort even during simple movements. At this stage, a doctor may recommend surgery.

Diagnosis of OA of the knee

An individual may not notice symptoms in the early stages of Osteoarthritis of the knee. If a person has knee pain, a doctor will ask about symptoms, including when and where pain and stiffness occur, whether the knee cracks or pops with movement, and how long any pain lasts in the morning. The doctor will also ask about personal and family medical histories and perform a full physical examination, including diagnostic tests.

Possible tests include X-rays to assess damage to the joint, MRI scans to help detect early signs that an X-ray may not reveal, and blood tests to help rule out other diseases, such as gout and rheumatoid arthritis. In some cases, a doctor may recommend a joint fluid test, which involves removing some fluid with a needle and sending it to a laboratory for testing. The results may show biomarkers of inflammation. However, experts do not recommend this unless there are signs of swelling that could indicate joint inflammation or synovitis. In this case, tests could help detect rheumatoid arthritis.

OA of the Knee Treatment Options

Treatment options for OA of the knee Treatment options for Osteoarthritis of the knee depend on the stage of OA and how quickly the condition is progressing. There is no cure for OA, but treatment can help manage the symptoms and improve quality of life.

Stage 1

At this stage, any symptoms are usually minor, and acetaminophen or other over-the-counter (OTC) medications can often relieve the pain. A doctor may recommend specific exercises to help build strength and mobility. According to the American Academy of Orthopaedic Surgeons (AAOS), there is not enough evidence to show that supplements such as glucosamine help.

Stage 2

At this stage, treatments can include taking pain relievers, attending physical therapy sessions to build or maintain strength and flexibility, wearing a knee brace designed to relieve pressure on the joints’ surfaces, and wearing shoe inserts to reduce stress on the knee. At this stage, it may be necessary to adapt or change daily activities to avoid pain.

Stage 3

At this stage, treatments can include taking OTC pain relievers, such as acetaminophen, taking prescription pain relievers, such as oxycodone and codeine, and receiving corticosteroid injections. In the past, people used hyaluronic acid to treat pain. However, both the American College of Rheumatology (ACR) and the Arthritis Foundation (AF) advise against this, as there is not enough evidence to show that it is safe or effective.

Stage 4

At this stage, the cartilage has either significantly diminished or completely worn away. A person can continue to use pain relief medication. A cane, walker, or brace can help them stay mobile. A doctor may recommend surgery to replace or realign the joint.

Alternative remedies for Osteoarthritis of the knee The ACR and AF recommend that a person reach a moderate weight, if applicable, obtain information on how to manage their situation, practice tai chi, use a knee brace, do balance exercises, practice yoga, and undergo cognitive behavioral therapy to help with pain, mood, and sleep problems. People may also try acupuncture, magnetic pulse therapy, or needle lavage, which involves inserting a needle into the joint and injecting a saline solution. However, the AAOS notes there is not enough evidence to confirm these treatments are safe or effective.

Stem cell therapy for Osteoarthritis of the knee Researchers have been investigating whether stem cell therapy can regenerate cartilage in people with OA. However, a number of challenges remain. For example, the therapy is expensive, a person may have to receive several rounds before they see results, and the treatment may be ineffective if a person’s body mass index is over 35. Some clinics offer stem cell therapy for OA, but the Food and Drug Administration (FDA) warned the public in 2017 not to “believe the hype.” The ACR and AF strongly recommend against using stem cell therapy, as there are no standards to regulate this practice. Side effects of unapproved stem cell treatments may include adverse reactions at the site of the injection, cells reproducing in the wrong location, failure of the cells to work as expected, and a risk of tumors.

Diagnosing OA of the Knee

OA of the knee is a progressive condition that affects the bones, cartilage, and synovium in the knee joint, leading to pain and stiffness. The condition progresses over time and can be classified into four stages, each with different symptoms and levels of severity. A doctor can diagnose Osteoarthritis of the knee through physical examination, X-rays, MRI scans, and blood tests.

OA Knee Treatment Options

Treatment options depend on the stage of OA and how quickly the condition is progressing. There is no cure for Osteoarthritis, but treatment can help manage the symptoms and improve quality of life. Treatment options include medications, physical therapy, braces, and surgery.

Alternative remedies such as acupuncture, magnetic pulse therapy, and needle lavage have been explored but lack sufficient evidence to confirm their effectiveness.

Stem cell therapy is an emerging treatment option, but it is still in the research phase, and there are concerns about its effectiveness and safety.

Overall, managing Osteoarthritis of the knee involves a combination of medical treatment, lifestyle changes, and alternative therapies, with the goal of reducing pain and maintaining mobility. If you are experiencing symptoms of Osteoarthritis of the knee, talk to your doctor about the best treatment options for you.

Patriciate in a OA Knee Clinical Trial

Participating in a clinical trial at Palm Beach Research Center can be a great way to access cutting-edge treatments and therapies for a variety of medical conditions, including osteoarthritis of the knee. If you are interested in participating in a clinical trial, you can click here to see if you prequalify. At Palm Beach Research Center, our team of medical professionals is dedicated to ensuring the safety and comfort of all our study participants, while providing them with access to the latest medical advancements. If you prequalify, one of our staff members will reach out to you to discuss the next steps in the enrollment process.