STAGES OF OSTEOARTHRITIS (OA) OF THE KNEE

Stage 0 (Normal)

Stage 1 (Minor)

Stage 2 (Mild)

Stage 3 (Moderate)

Stage 4 (Severe)

Stage 1 (Minor)


A person with stage 1 OA is showing very minor bone spur growth.

Bone spurs are bony growths that often develop where bones meet each other in the joint. There might be minor loss of cartilage but not enough to compromise the joint space.

Someone with stage 1 OA will usually not experience any pain or discomfort as a result of the very minor wear on the components of the joint.

Treatments for curing stage 1 of OA

Without outward symptoms of OA to address, most doctors won’t require you to undergo any treatments for stage 1 OA.

However, if you have a predisposition to OA or are at an increased risk, your doctor may recommend you begin an exercise routine to help relieve any minor symptoms of OA and to try to slow the progression of the arthritis.

Stage 2 (Mild)


Stage 2 OA of the knee is considered a mild stage of the condition. At this stage, synovial fluid is also typically still present at sufficient levels for normal joint motion.

However, this is the stage where people may first begin experiencing symptoms, such as:

l  Pain after a long day of walking or running

l  Greater stiffness in the joint when it’s not used for several hours

l  Tenderness when kneeling or bending

X-rays of knee joints in this stage will show mildly reduced joint space but the bones aren’t rubbing or scraping one another.

Treatments for curing stage 1 of OA

Talk with your doctor about the signs and symptoms of OA. They may be able to detect and diagnose the condition at this early stage. If so, you can develop a plan to prevent the condition from progressing.

Several different therapies can help relieve the pain and discomfort caused by this mild stage of OA. These therapies are mainly nonpharmacological, which means you don’t need to take medication for symptom relief.

If you’re overweight, losing weight through diet and exercise can help relieve minor symptoms and improve your quality of life. Even people who aren’t overweight will benefit from exercise.

Low-impact aerobics and strength training can help strengthen the muscles around the joint, which increases stability and may decrease the likelihood of additional joint damage.

Protect your joint from exertion by avoiding kneeling, squatting, or jumping.

Some people may require medications for mild pain relief. These are usually used in conjunction with nonpharmacological therapies.


Stage 3 (Moderate)


Stage 3 OA is classified as moderate OA. In this stage, the cartilage between bones shows obvious damage, and the space between the bones becomes more narrow.

People with stage 3 OA of the knee are likely to experience frequent pain when walking, running, bending, or kneeling.

They may also experience joint stiffness after sitting for long periods of time or when waking up in the morning. Joint swelling may be present after extended periods of motion as well.

Treatments for curing stage 3 of OA

If you have stage 3 OA, you should continue with nonpharmacological therapies such as exercise and weight loss.

People with stage 3 OA will also continue to receive NSAIDs or acetaminophen. If your OA medications are causing side effects, you should speak with your doctor about switching to a different one. Also, topical forms of NSAIDs and capsaicin  can be tried.

If NSAIDs or acetaminophen are no longer effective at all, prescription pain medication, or tramadol , can help relieve the increased pain common in stage 3 OA. Experts conditionally recommend tramadol over other opioids for people with knee OA.

Side effects of these medications include:

  • Nausea
  • Sleepiness
  • Constipation
  • Fatigue

If nonpharmacological therapies or pain relievers don’t work or no longer provide the pain relief they once did, your doctor may also recommend a class of medications known as glucocorticoids.

Injections

Glucocorticoids are types of corticosteroid drugs. Corticosteroids include cortisone, a hormone which has been shown to relieve OA pain when injected into the affected joint.

The effects of a corticosteroid injection may wear off in about 2 or 3 months, after which the injections may be repeated.

Stage 4 (Severe)

Stage 4 OA is considered severe. People in stage 4 OA of the knee experience great pain and discomfort when they walk or move the joint.

That’s because the joint space between bones is dramatically reduced.

The cartilage is almost completely gone, leaving the joint stiff and possibly immobile. The synovial fluid is decreased dramatically, and it no longer helps reduce the friction among the moving parts of a joint.


Treatments for stage 4

Available treatments for Stage 4 OA include surgery.

Bone realignment surgery/ High Tibial Osteotomy (HTO)

Bone realignment surgery, or osteotomy, is one option for people with severe OA of the knee. During this surgery, a surgeon cuts the bone below the knee to correct its alignment. This surgery shifts the weight of your body away from the points of the bone where the greatest bone spur growth and bone damage have occurred. This surgery is typically performed on younger people.

Unicondylar knee replacement(UKR) / Total knee replacement (TKR)

Total knee replacement(TKR), or arthroplasty, is available for severe, persistent pain and decreased function for people with severe OA of the knee. During this procedure, a surgeon removes the damaged joint and replaces it with a plastic and metal device. The newer knees last for decades.





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