Knee pain that occurs more frequently, especially when walking, climbing stairs, or even waking up, could be a sign of knee osteoarthritis . This condition is a gradual wear and tear of the joints that can worsen over time.
However, not all osteoarthritis requires surgery. Treatment depends largely on the stage or degree of joint damage experienced by the patient.
At EMC Pekayon Hospital, Bekasi, a comprehensive osteoarthritis evaluation is carried out by a hip & knee subspecialist, Dr. Othdeh Samuel, Sp.OT, FICS, Subsp PL (K), AIFO-K , to determine the most appropriate and safe therapy according to each patient's condition.
What is Knee Osteoarthritis?
Osteoarthritis (OA) of the knee is a condition in which the cartilage lining the ends of the bones in the knee joint thins and breaks down. Cartilage acts as a cushion to keep the joint moving smoothly and prevent friction.
When these cushions wear down, the bones can rub against each other, causing:
- Pain when moving
- Stiffness in the knees, especially in the morning
- Mild swelling
- Sound in the knee when moved
- Change in the shape of the legs to O or X
Osteoarthritis is progressive, meaning the condition can get worse if not treated properly.
Stages of Knee Osteoarthritis
In the medical world, the degree of osteoarthritis is usually assessed through a clinical examination and a standing (weight-bearing) X-ray. The following is a general overview of the stages of osteoarthritis:
Stage 1 (Mild)
In the early stages, joint damage is minimal. Joint space remains normal, and symptoms are usually mild.
Patients may experience occasional pain after strenuous activity or prolonged standing.
Handling at this stage usually includes:
- Education and activity modification
- Thigh muscle strengthening exercises
- Weight management
- Pain medication if needed
Surgery is not necessary at this stage.
Stage 2 (Mild–Moderate)
At this stage, cartilage thinning begins to occur and small bone growths appear around the joints (osteophytes).
Symptoms start to appear more frequently, such as:
- Pain when walking long distances
- Knees feel stiff after sitting for a long time
- Uncomfortable when going up and down stairs
Treatment is still focused on non-operative therapy such as:
- Programmed physiotherapy
- Anti-inflammatory drugs
- Joint injections for certain indications
Stage 3 (Moderate–Severe)
The joint space narrows and friction between the bones becomes noticeable. Pain can occur even with light activity.
At this stage, daily activities begin to be disrupted, such as:
- It's hard to walk long distances
- Uncomfortable while praying
- Difficulty squatting or standing for long periods
Conservative therapy can still be tried, but in some patients whose complaints are severe and do not improve, surgery is considered.
Stage 4 (Severe)
This is the most advanced stage. The joint space is almost or completely gone, so the bones rub together directly.
Common symptoms:
- Persistent pain, including at rest
- Sleep disturbance due to pain
- Obvious O or X shaped legs
- Walking limitations
In this condition, Total Knee Replacement (knee joint replacement surgery) is often the most effective therapy option to reduce pain and improve knee function.
When Does Knee Osteoarthritis Require Surgery?
The decision to operate is not only based on the X-ray results, but also takes into account:
- The level of pain felt by the patient
- How much disruption to daily activities
- Response to medication and physiotherapy
- General health condition of the patient
If non-operative therapy is no longer effective and quality of life is severely impaired, then surgery may be the right solution.
The Importance of Evaluation by a Hip & Knee Subspecialist
Every patient's condition is different. Therefore, an examination by a hip and knee specialist is essential to assess:
- Degree of joint damage
- Foot alignment
- Ligament stability
- Individual therapy needs
The right approach early on can help slow the progression and prevent complications later on.
Knee Pain Consultation in Bekasi
If you experience chronic knee pain, your knee feels stiff, makes noises, or starts to change shape, don't wait until the symptoms get worse.
Get evaluated immediately, because proper treatment can help you stay active, move comfortably, and maintain your long-term quality of life.
Article written by Dr. Othdeh Samuel, Sp.OT, FICS, Subsp PL (K), AIFO-K (Orthopedic & Traumatology Specialist, Hip & Knee Subspecialist, EMC Pekayon Hospital – Bekasi).