Stages of knee osteoarthritis

Stages of Knee Osteoarthritis

Welcome to the One Care Medical Center, which is by far one of the best orthopedic hospital in Coimbatore. In this post we are going to discuss the stages osteoarthritis

Osteoarthritis in any area of your body is categorized by five stages. It starts at Stage 0, which indicates no sign of osteoarthritis at all. The worst and final stage of osteoarthritis is Stage 4. Stage 4 osteoarthritis can cause severe pain and will significantly interfere with your joint mobility. In this article, we will go through the symptoms of each stage and their corresponding treatments.

Stage 0

This stage of osteoarthritis indicates a normal, healthy knee. There is no pain or sign of joint deterioration.


There is no treatment required for a healthy knee.

Stage 1

The main symptom of Stage 1 is a mild growth of bone spurs. These are small extra bone growths that emerge where two bones meet around the joint. There is not much pain from this stage of osteoarthritis, but a strange sensation might be noticeable.


If you are not experiencing such symptoms or pain, your doctor is likely to not recommend any extra treatment for this stage of osteoarthritis.

There are such cases, though, wherein the patient has other risks accompanying their osteoarthritis. If you are such a case as this, one possible recommendation is food supplements. These would be chondroitin or glucosamine. Physical or exercise therapy is also a useful, natural way to strengthen your joints from the deterioration that osteoarthritis can cause.

Stage 2

In Stage 2 osteoarthritis, the condition is noticeable but still considered mild. You are likely to be recommended an X-ray, wherein you will see further growths of bone spurs despite your cartilage still looking healthy. Since the cartilage is still operating well, you won’t be feeling your bones scraping around just yet. Your synovial fluid levels would also be normal.

Since there are bone spurs, though, you might start experiencing pain at this point, especially after strenuous activities or long periods of being sedentary.


This stage of osteoarthritis is usually the stage by which you are diagnosed. Treatment, as well as prevention, is likely to be recommended by your doctor.

There are different options for treating osteoarthritis at this stage. These can be medicinal or therapeutic. Physical therapy can help strengthen your joints and even provide pain relief. Doctors may also recommend light exercise to help you lose weight, since being overweight can create extra strain on your knee joints. Even if you’re of normal weight, exercise and a proper diet can still improve your disposition to osteoarthritis.

Examples of light exercise would be strength training, light resistance training, and even light aerobics. The kind of exercise that you should avoid is jumping, kneeling, and squatting. To keep your knee stable, it is best to wrap it or keep it in a brace. There are also shoe inserts made to align your leg, as well as redirect the pressure on your knee down to your foot.

If the pain begins to interfere with your daily activities, consult a doctor for pain medication. These can be done along with your physical therapies. Pain medication can come in the form of Non-steroidal Anti-Inflammatory Drugs or NSAIDs, or Tylenol, which is a type of acetaminophen. Accompany these medications with proper diet and exercise.

Note that it is not advisable to stay on these medicines for long term. NSAIDs, when used for a long time, have been related to cardiovascular disease, liver damage, kidney damage, and stomach ulcers.

Stage 3

In its 3rd Stage, osteoarthritis is considered “moderate.” The cartilage is already significantly damaged and bones are meeting closer than they should be. Because of this, patients of stage 3 osteoarthritis are more prone to pain, especially when doing physical activities like kneeling, walking, bending, and running.

Joint stiffness is another source of pain for patients with stage 3 osteoarthritis. After several hours of staying in one position, even when sleeping, moving your joints can be a painful experience because of the swelling.


By stage 3, osteoarthritis is not very treatable through physical therapy only. The doctor will likely prescribe to you a corticosteroid.

A corticosteroid is a type of drug that contains cortisone. This is a hormone that allows pain relief and is usually injected straight into your body into a site near the source of pain. Although cortisone is a drug, your body produces its cortisone naturally.

These injections may be up to four times a year. There is a certain drug, however, the triamcinolone acetonide should only be injected once. A corticosteroid injection will last for around two months, but do not be so quick to ask for another injection right away. There have been studies that have found corticosteroids to increase joint damage when used too often and long-term.

If the pain of stage 3 osteoarthritis cannot be relieved by NSAIDs, you can be prescribed other pain relievers like oxycodone or codeine. Over short periods, patients can take these for pain relief.

As mentioned, there are risks of long-term effects. You may also experience side effects such as fatigue, sleepiness, and nausea.

Another option is viscosupplementation. These are hyaluronic acid injections straight into your arteries. Hyaluronic acid is a highly hydrating substance. The viscosupplement can be administered about a week apart or can be given in one dose.

Patients will probably not see immediate improvement after viscosupplementation, but it does help osteoarthritis in the long-term. The relief will take effect after several weeks and will relieve pain for months. However, not every patient responds as well to this sort of treatment.

Stage 4

The most severe and painful stage of osteoarthritis is Stage 4, wherein patients experience discomfort even in normal physical daily activities, and intense pain in strenuous activities.

In stage 4 osteoarthritis, there is barely any space left between your bones and your cartilage has almost fully deteriorated. This leaves your knee joint mostly immobile. Synovial fluid, which helps lubricate the joint, is not being produced as much as it should, leaving your joint stiff and difficult to move.


At this severe stage of osteoarthritis, surgery may be recommended. The doctor may have you set for an osteotomy which is a realignment surgery. In this process, the surgeon will change the length or alignment of your knee by cutting into the bone surrounding the knee.

The surgery’s purpose is to change where your body weight affects your joints. It is meant to redirect the weight from the damaged joint to your remaining healthy bones. However, this is mostly recommended for younger patients.

For those who are aged and with stage 4 osteoarthritis, the doctor may recommend arthroplasty or a full knee replacement. The surgeon will simply take out your deteriorated joint and insert an artificial device in its place.

Possible side effects are blood clots and infections, so recovery must be done properly and with physical therapy to assist the healing.

It is normal for patients to still experience knee problems after surgery, but the artificial knee is meant to allow you the mobility and functionality that a patient loses with severe osteoarthritis.