Osteoarthritis (OA) is categorized into five stages. Stage 0 represents a normal, healthy knee, while the highest stage, 4, represents severe OA. OA that has advanced to stage 4 is likely to lead to severe pain and cause disruptions in joint movement.
Board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler provide treatments for the knee, shoulder and other joints to patients in Las Vegas, Nevada, and surrounding communities.
Stage 0 OA is assigned to a healthy knee. The knee does not show any indications of OA and the joint functions without any pain or impairment.
Stage 0 OA does not require any treatment.
Patients with stage 1 OA displays very minor bone spur growth. Bone spurs refer to boney growths that usually develop where bones connect to each other in the joint.
People with stage 1 osteoarthritis do not typically experience any pain or discomfort due to the minor degeneration of the components of the joint.
If a person has a genetic predisposition for arthritis or is at a higher risk, the doctor may recommend that they take supplements such as glucosamine and chondroitin, or start an exercise regimen to relieve any minor OA symptoms and slow the progression of the condition.
Stage 2 knee OA is considered a “mild” stage of the disease. X-rays of the knee joints in stage 2 will reveal increased bone spur growth. However, the cartilage is typically still at a healthy size, i.e., the space between the bones is normal, and the bones are not scraping or rubbing against each other.
The synovial fluid is also usually still present at appropriate levels for normal joint movement at this stage.
Various therapies can help relieve the discomfort and pain caused by stage 2 of osteoarthritis. These treatments are primarily non-pharmacologic. This means that the patient does not need to take medication for the relief of symptoms.
Stage 3 OA is categorized as “moderate” osteoarthritis. There is obvious damage to the cartilage between the bones in this stage. The space between the bones starts narrowing as well. Stage 3 knee OA patients will likely experience recurring pain when running, bending, kneeling or walking.
In case nonpharmacological therapies do not work or no longer offer pain relief, the doctor may recommend cortisone injections to the patient. Cortisone is a steroid that is manufactured naturally by the body. It has been shown to provide relief from pain when injected near the impacted joint.
Doctors consider stage 4 OA “severe.” Individuals in stage 4 experience significant pain and discomfort upon walking or moving the joint.
The reason for this is that the joint space between the bones is substantially reduced and the cartilage is almost entirely gone. Therefore, the joint becomes stiff and likely immobile.
One option for people with severe OA of the knee is bone realignment surgery or osteotomy. In this procedure, a surgeon cuts the bone above or below the knee to reduce it, lengthen it, or change its alignment. This surgical procedure is usually done in younger patients.
Total knee replacement (arthroplasty) is the last resort for a majority of patients with stage 4 osteoarthritis. In this procedure, a surgeon excises the damaged joint and replaces it with a plastic and metal device.
It will take the patient several weeks or months to recover from this surgery, and they will require extensive physical and occupational therapy.
Board certified orthopedic surgeons Dr. Steven C. Thomas and Dr. Gregory T. Bigler receive patients for knee, shoulder and other joint treatments from Las Vegas, Nevada, and nearby areas.
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