Leon E. Popovitz, MD
Top-Rated Orthopedic Surgeon
Specializing in Arthroscopic Surgery of the Shoulder & Knee.
For appointments 212.759.4553

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The 4 Stages of Knee Arthritis

Although there are several forms of arthritis, osteoarthritis (OA) is the form that most often affects the knees. OA causes the degeneration of the cartilage in the knee joint due to bony growths known as osteophytes. When this cartilage is damaged the result is the common symptoms associated with arthritis such as pain, swelling and stiffness in the joint.

OA of the knee is a progressive condition and can become more severe over several years. In many cases, patients only realize they are affected with this condition when they begin to experience pain or stiffness. Below are the 4 stages of OA as well as ways to treat this condition in its various stages.

Stage I: Minor

During this first phase, there are minimal signs of osteoarthritis other than small formations of bone on the knee joint, known as osteophytes. These formations are often too small to appear on an X-Ray and will cause little to no discomfort in the knee. 

Treatment: Over the Counter Medication

If any discomfort is present, over the counter medication and rest are often all that is needed to resolve discomfort.

Stage 2: Mild

This is the phase in which most patients realize that there may be an underlying issue in the knee and may begin to feel intermittent pain or stiffness. During this second phase, the osteophytes are larger are visible via X-Ray and the cartilage has begun to thin as a result of these larger growths. Also, the tissue within the knee joint has begun to harden and as a result thicken the bones of the knee. However, there is still some cartilage between the knee joints and the bones are not directly contacting one another.

Treatment: Physical Therapy

Physical Therapy is the most effective form of treatment in this phase. The goal of Physical Therapy will be to strengthen and stabilize the knee joints as well as the quadriceps muscles in an effort to reduce pain. Bracing may also be recommended as well minor activity modification.

At New York Bone and Joint, Physical therapy and sports rehabilitation services are provided on site at each location by our affiliate, All Sports Physical Therapy. Our physical therapists work together as a team and are proven to have excellent outcomes for bone and joint conditions.

Stage 3: Moderate

During this third phase, it is important to consult a specialist (if you have not already). As the condition has progressed, the cartilage between the bones of the knee is significantly reduced and the bones have become substantially thickened.  Commonly, the tissue within the joint will become painful and inflamed and patients will experience persistent discomfort when running, kneeling, bending or standing for an extended period of time and swelling in the knee is common.

Treatment: Injection Therapy

Depending on which area of the knee is damaged, several injection therapy options exist.  Many of these injections will utilize anti-inflammatory medications and corticosteroids to reduce pain and swelling. Others, known as viscosupplementation, are used to replicate the naturally occurring lubricating fluid with knee joint (hyaluronic acid). These injections are often utilized in conjunction with continued Physical Therapy.

At New York Bone and Joint, our comprehensive Pain Management Team is led by Board Certified Physiatrist and Physical Medicine and Rehabilitation Specialist, Dr. Michael Mizhiritsky. Dr. Mizhiritsky and the Pain Management Team offer a wide range of possible treatment options to manage both acute and chronic pain. After an evaluation, a doctor can recommend the most appropriate treatment plan to rehabilitate the body and restore a patient’s lifestyle. 

Stage 4: Severe

This is the most severe phase of OA and pain, swelling and stiffness are often constant. X-Rays will show that the bones of the knee have begun to rub together due to their being little to no cartilage left between the bones. Also, the naturally occurring lubricating fluid in the knee is no longer present in the knee.

Treatment: Joint Replacement Procedures

At this point, the most beneficial option for a patient to consider is a Joint Replacement Procedure. Depending upon where arthritis is most present and the severity of the damage to the joint, either a Partial Knee Replacement or Total Knee Replacement will be recommended. The typical Knee Replacement Procedure replaces the ends of the femur (thigh bone) and tibia (shin bone) with plastic inserted between them and usually the patella (knee cap).

At New York Bone and Joint, out Joint Replacement Team is led by Fellowship trained Joint Replacement Expert, Rupesh Tarwala, MD. Our experienced Orthopedic Specialists evaluate and treat conditions requiring joint replacement surgery and offer expert advice on the best course of action.

NY Bone and Joint Specialists is a top rated, private Orthopedic and Sports Medicine practice in with locations in New York City, Hoboken and Englewood, NJ. The Orthopedic SurgeryPhysical Medicine & Rehabilitation, and Pain Management specialists routinely perform surgical and non-surgical treatments for professional athletes from across the United States and various other countries. Dr. Leon Popovitz and Dr. Michael Mizhiritsky, along with their team of best in class orthopedic physicians, are known for their exemplary orthopedic surgical skill and best rated physical medicine and rehabilitation program. This, along with their top in-office physical therapy and long-term sports rehabilitation processes, leads to athletes of all levels returning to their top physical potential. Contact us today to schedule a consult!

 

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