Stages of Knee Osteoarthritis

Osteoarthritis (OA) is divided into five stages. Stage 0 corresponds to a normal and healthy knee, while stages 1-4 are pathological, the last stage is severe osteoarthritis. At this advanced stage, osteoarthritis can cause significant pain and disrupt normal movements.

Step 0

Stage 0 is classified as “normal” knee health. The knee joint shows no signs of osteoarthritis, the mobility of the joint is not affected and there is no pain. In stage 0 of osteoarthritis, no treatment is needed.

Stage 1

Stage 1 of osteoarthritis is characterized by the appearance of very small bone growths (bony spurs). These bone growths are bone growths that often develop when the bones meet in the joint.

At this stage of osteoarthritis, there is no pain or discomfort in the knee joint due to very little wear of the joint components.


It is not mandatory to follow a treatment because there are no external symptoms.

However, if a patient is prone to osteoarthritis or is at increased risk of developing this disease, rheumatologist in Delhi recommends treatment with supplements such as glucosamine or chondroitin, or starting routine exercises to prevent minor symptoms of osteoarthritis or to slow the progression of arthritis.

Stage 2

Stage 2 of osteoarthritis is considered the “mild” stage of this condition. At this stage, an x-ray of the knee will reveal a more pronounced growth of the bone, but the cartilage is usually still at a normal, healthy size. In this case, the space between the bones is normal and the bones do not rub against each other.

Synovial fluid is also present in sufficient amounts to ensure normal joint movement. Synovial fluid is a clear, sticky fluid that lubricates the joint, reducing friction and improving joint mobility.

However, at this stage the symptoms characteristic of osteoarthritis may occur:

– pain (after a long day of walking or running);

– greater stiffness in the joint (when it is not used for several hours);

– sensitivity (when the patient kneels or bends the knee).


At this early stage, the best rheumatologist in Delhi will detect and diagnose the condition of the patient’s knee and the level of development of OA, but for a correct diagnosis, the doctor must know very well the signs and symptoms present in the patient.

There are several therapies that can help relieve the pain and discomfort caused by this mild stage of osteoarthritis. In general, these therapies are non-pharmacological, which means that no medication is needed to relieve the pain.

Aerobic exercise and resistance training can help strengthen the muscles around the joint, which increases stability and decreases the likelihood of further joint damage.

The joint must be protected from exertion by avoiding kneeling, squatting or jumping. Knee pads can help stabilize the knee. Shoe soles can help adjust the foot and reduce pressure on the joint.

Some patients may request medication for mild pain relief. These are commonly used in conjunction with non-pharmacological therapies.

For example, the administration of non-steroidal anti-inflammatory drugs is very well associated with exercise, weight loss, and protection of the knee from stress.

Long-term treatment with nonsteroidal anti-inflammatory drugs can cause other problems, can cause stomach ulcers, cardiovascular problems, or kidney and liver damage.

Stage 3

Stage 3 is classified as a “moderate” stage of osteoarthritis. At this stage, the cartilage between the bones shows obvious damage, and the space between the bones begins to narrow.

Patients with stage 3 OA are likely to have frequent pain when walking, running, bending, and kneeling.

They may also have joint stiffness after sitting for long periods of time or in the morning, and after long periods of movement, swelling of the joints may occur.


If non-pharmacological therapies do not work and do not relieve pain and discomfort, cortisone injections are recommended.

Cortisone, a steroid produced naturally by the human body, has the effect of relieving the pain caused by osteoarthritis when injected near the affected joint.

The effects of an injected dose of cortisone disappear in about 2 months. However, it is recommended that the administration of cortisone doses be closely monitored by an arthritis specialist in Delhi.

Studies have shown that long-term use of the steroid can even worsen the joint damage.

If nonsteroidal anti-inflammatory drugs are no longer effective, medications, such as codeine and oxycodone, can help relieve the intense stage 3 pain of osteoarthritis. In the short term, these medications can be used to treat moderate to severe pain.

Narcotic drugs are not recommended for long-term use due to the risk of increased tolerance and possible dependence.

People who do not respond to conservative treatments for physiotherapy of osteoarthritis, weight loss, administration of nonsteroidal anti-inflammatory drugs or analgesics, may resort to infiltrations with hyaluronic acid in the knee. Hyaluronic acid is a natural component of synovial fluid.

The technique involves injecting synthetic hyaluronic acid preparations directly into the knee joint, which tend to replace the joint fluid. This osteoarthritis treatment in Delhi requires 1 to 5 injections of hyaluronic acid per week.

The effect of these injections is not immediate, it takes a few weeks for the full effect to be fully felt by the patient, and the effect usually lasts for several months. Not all patients respond to this treatment.

Step 4

This stage is considered a severe stage of osteoarthritis. Patients with stage 4 OA experience intense pain and discomfort when walking or moving the joint.

At this stage the joint space between the bones is dramatically reduced, the cartilage is almost completely damaged, and the joint becomes rigid and almost immobile. Synovial fluid drops dramatically and no longer helps reduce friction.


An osteotomy is an option for patients with severe osteoarthritis. This is the surgical sectioning of a bone in order to change its axis, size, or shape performed by orthopaedic surgeon in Delhi. This surgery is often effective in younger patients.

Arthroplasty is the last option for patients with stage 4 OA. This surgery involves removing damaged ligaments and articular cartilage and implanting a prosthesis.

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