Condition · Knee
Knee osteoarthritis
Knee osteoarthritis is the degeneration of one or more compartments of the knee. Radiographs show structural changes, but the treatment plan is guided by pain, stability, range of motion, deformity and the effect on the patient's life.
Clinical context
What you should know
Osteoarthritis may be primary, post-traumatic or associated with limb-alignment problems, meniscal damage and inflammatory disease. A degenerative meniscal tear may be part of the same process and is not necessarily a reason for arthroscopy.
Pain does not correlate perfectly with the radiographic grade. The examination distinguishes knee osteoarthritis from problems arising in the hip, spine, tendons or circulation.
First step
Consultation and assessment
Weight-bearing radiographs, including axial patellar views and sometimes full-length alignment views, show the affected compartments and deformity. MRI is not routinely required when the diagnosis is clear on radiographs.
Assessment covers range of motion, ligament stability, strength, gait, weight, associated medical conditions and the response to treatments already tried.
Stepwise treatment
Options are chosen according to the diagnosis and treatment goal
Conservative treatment
- exercises for strength, movement and neuromuscular control, tailored to pain and ability
- weight loss when appropriate and choosing lower-impact activities
- painkillers or anti-inflammatory medication after assessing gastrointestinal, kidney and cardiovascular risks
- a brace, walking stick or injection in selected cases, with realistic expectations about how long any benefit may last
Medication, injections and devices each have their own indications and contraindications. They are not recommended automatically and do not replace a diagnosis or monitoring of the response.
When surgery is considered
Total knee replacement is considered when osteoarthritis is advanced, pain and functional limitation remain substantial, and reasonable non-surgical measures no longer provide adequate relief. Arthroscopy is not a routine treatment for diffuse osteoarthritis.
Do not delay
Signs that require prompt assessment
- a red, hot and very swollen knee, especially when accompanied by fever
- inability to bear weight or deformity after an injury
- sudden calf swelling, shortness of breath or chest pain
In an emergency or if symptoms are severe, call 112 or go to the nearest emergency department.
Frequently asked questions
Concise answers, without blanket promises
Is an MRI required before knee replacement?
Usually not. Weight-bearing radiographs and the clinical examination provide the main information; additional tests are requested only if they may change the plan.
Can an injection cure osteoarthritis?
No injection restores the cartilage. Some injections may temporarily reduce symptoms in selected patients, and their potential benefits and limitations should be discussed individually.
Editorial responsibility
Medically reviewed content
Dr. Răzvan Anițaș
Consultant orthopaedic and trauma surgeon; PhD in medical sciences
Last editorial update: 22 August 2026
Medical reference sources
First step
Consultation, diagnosis and a clearly explained plan
This content is educational and does not replace medical assessment. Similar symptoms can have different causes and require different treatments.