Knee Osteoarthritis: A Modern Guide to an Age-Old Ailment

Knee osteoarthritis (OA) is the leading cause of disability among adults over 50—and one of the most misunderstood. Often dismissed as “just wear and tear,” this progressive joint disease is now understood to be far more complex—and far more treatable.

Today’s patients have access to a wide range of therapies, from weight management and physical therapy to advanced injections and minimally invasive procedures that target nerves or blood vessels. Some can delay or even replace the need for surgery

Here’s what you need to know.

Understanding the Condition

Osteoarthritis is a degenerative disease that gradually breaks down the cartilage that cushions your joints. As cartilage thins, bones may grind together, causing pain, stiffness, and inflammation. Bone spurs can develop, further limiting movement.

Knee OA most commonly affects older adults, but it can strike younger individuals too—especially those with a history of knee injuries, high-impact sports, or obesity.

Symptoms to Watch For

Knee OA doesn’t develop overnight. Common signs include:

• Pain with activity

• Morning or post-rest stiffness

• Swelling or warmth

• Cracking, grinding, or popping sounds

• Loss of flexibility or range of motion

• Trouble walking, climbing stairs, or standing for long periods

Risk Factors and Related Conditions

Several health factors can increase the risk or worsen OA:

• Obesity, which multiplies the force on your knees with every step

• Diabetes and metabolic syndrome, which trigger low-grade inflammation

• Previous injuries such as ACL tears or meniscus damage

• Occupational or athletic overuse

Diagnosis: 

A diagnosis typically includes:

• A clinical exam to assess joint motion, alignment, and tenderness

• X-rays to detect bone changes and cartilage loss

• MRI scans in some cases to view soft tissues

• Blood tests to rule out other causes of joint pain

Conservative Management: The First Line of Defense

Lifestyle Interventions

• Weight loss: Losing even 10 pounds can take 40–60 pounds of pressure off your knees with each step.

• Exercise: Strengthening the quadriceps and hips helps support the joint. Low-impact options like swimming, cycling, and yoga improve flexibility and endurance.

Physical Therapy

• Tailored rehab programs can correct poor movement patterns, reduce pain, and improve balance and function.

Medications

• NSAIDs like ibuprofen or naproxen relieve inflammation and pain.

• Topical NSAIDs and capsaicin creams are good alternatives with fewer systemic side effects.

• Acetaminophen offers modest pain relief.

• Duloxetine, an antidepressant, is also FDA-approved for chronic musculoskeletal pain.

Intra-Articular Injections: Targeted Relief

Corticosteroid Injections

• These anti-inflammatory medications are injected directly into the knee joint for rapid pain relief—often within days.

• The benefits typically last 4 to 8 weeks, though repeated injections may wear down cartilage over time.

Hyaluronic Acid (Viscosupplementation)

• This gel-like substance mimics natural joint fluid and is injected to lubricate the knee, often over a series of sessions.

• Results vary: some patients report months of relief, while others notice little change.

• May be best for mild to moderate OA, especially if steroid injections have failed.

Platelet-Rich Plasma (PRP)

• Derived from your own blood, PRP contains growth factors that may support tissue healing.

• Some studies show PRP is more effective than hyaluronic acid in improving symptoms—but results are still mixed and depend on technique and patient selection.

Stem Cell Injections

• These are marketed as regenerative, but most options remain experimental, with unclear long-term results and no current FDA approval for OA.

Minimally Invasive Interventional Therapies

Genicular Nerve Ablation (GNA)

This non-surgical procedure uses radiofrequency energy to disable small sensory nerves that transmit pain from the knee. It:

• Offers 6 to 12 months of pain relief

• Preserves motor function

• Is ideal for patients who are not ready for knee replacement

Clinical trials show significant improvement in both pain and function, with minimal risks.

Genicular Artery Embolization (GAE)

A cutting-edge outpatient procedure, GAE works by reducing blood flow to inflamed parts of the knee:

• A catheter is inserted into the femoral artery, then into the knee’s genicular arteries.

• Tiny particles are injected to block abnormal blood vessels, reducing inflammation and pain.

• A 2024 study presented at the Radiological Society of North America reported a 71% reduction in pain and 87% improvement in quality of life at 12 months.

GAE is currently used mostly in research settings or specialized centers, but it’s rapidly gaining attention as a way to delay or avoid knee surgery.

New Research: Weight Loss Drugs, Biologics, and More

Semaglutide and GLP-1 Medications

Originally developed for diabetes and obesity, semaglutide has demonstrated remarkable benefits for patients with knee OA:

• A 2024 study in Nature Reviews Rheumatology found that patients who lost weight using semaglutide saw up to 50% improvement in pain and mobility.

• Benefits are attributed to both weight reduction and anti-inflammatory effects.

Biologics and Gene Therapy

Biologic drugs that block inflammatory proteins (like IL-1 and TNF-alpha) and experimental gene therapies are under study as future disease-modifying OA treatments. While not yet standard care, these therapies could revolutionize how we treat joint degeneration at its root.

Surgical Options: When All Else Fails

Partial Knee Replacement

Replaces only the damaged part of the knee. Less invasive and quicker to recover from than total replacement.

Total Knee Replacement (TKR)

The gold standard for advanced OA. Modern implants last 15 to 20 years and can dramatically improve quality of life.

Osteotomy

Realigns bones to offload pressure from the damaged area. Often used in younger, active patients.

Final Thoughts

Knee osteoarthritis is no longer a slow march toward joint replacement. With early diagnosis and the right combination of treatments—ranging from physical therapy and injections to cutting-edge interventional procedures—many patients can delay or even avoid surgery entirely.

Whether you’re newly diagnosed or living with chronic pain, talk to your physician about the full spectrum of options. Today, treatment isn’t just about managing symptoms—it’s about reclaiming your movement, independence, and quality of life.

This content is for educational purposes only and does not constitute medical advice. No doctor-patient relationship is established through this platform. Always consult your healthcare provider before making medical decisions.