Knee Osteoarthritis

Apr 21, 2023
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The most common problem I see in my office is knee osteoarthritis. Its often the source of medical problems that accompany weight gain from inactivity. There are treatment options available. You don't have to live with pain. You can be active!

What is osteoarthritis (OA) of the knee?

A healthy knee joint contains synovial fluid, a naturally occuring viscous liquid responsible for lubricating the joint and absorbing shocks.  Synovial fluid also has anti-inflammatory and

analgesic effect.  Hyaluronic acid (HA) is a major component of normal synovial fluid and contributes to the fluid’s viscoelastic properties. 

With OA of the knee, HA in the synovial fluid breaks down and doesn’t work as well to lubricate the joint. Over time, increased friction between the cartilage surfaces can cause them to wear away.  Loss of the joints structural integrity causes irritation and inflammation that may increase pain and lead to swelling, stiffness and instability.  Pain from OA of the knee may be worse during weight-bearing activities, particularly when climbing stairs or bending. For some people, pain may be present even at rest.

Several thing are thought to contribute to the development of OA of the knee, such as:

  • Excessive wear and tear on the knee joint
  • Aging
  • Heredity
  • Traumatic injury
  • Weight gain
  • Repetitive stress injuries

Women aged 50 and over may be more likely to develop OA of the knee; however, it can affect both men and women earlier in life.  You may find yourself with limited movement and having to modify your activities to avoid or reduce your knee pain.

OA stages:

OA is a degenerative, progressive disease.  The symptoms should not be ignored.

Knee pain is not an indicator of how far your OA of the knee has progressed, as pain is different for each patient.  Be sure to monitor your knee pain and report the impact it's having on your life so you can find the relief you need based on your experience.

Can exercise help OA Knee pain?

Arthritis could be a perfect excuse not to exercise, but in reality, an exercise program developed and supervised by a professional who specializes in patients with OA knee pain could help decrease pain while maintaining flexibility, improving strength, and fitness level. 

For people with OA, three types of exercises are recommended:

  • Range-of-motion exercises
  • Endurance or aerobic exercises
  • Strengthening exercises


Exercises such as walking, biking, swimming and water aerobics are easy on your knees.

  • Exercising in water takes the weight off your painful joints.
  • Losing weight by being active alleviates stress on your knees. Even a small amount can make a big difference. 
    • 5 lb. of weight loss represents 20 lb. less wear and tear.


  • Start slowly, about 10 minutes a day.  If you are pain free, gradually increase frequency and intensity until you reach your goal.
  • It is normal to have mild muscle soreness. Rest when you experience any pain or swelling in your knee.

Add simple exercises to your routine, specifically exercises that will help strengthen your quadriceps, hamstrings, and glutes, the muscles that help your knees function.

Find the right treatment for you

Your knee pain, the impact it’s having on your life, and what has or has not worked previously will help decide what treatment options to use next. 

Common treatment options that may provide pain relief from OA of the knee:

Over-the Counter Pain Relievers

  • Acetaminophen (Tylenol)

Drugs That Treat Inflammation

  • Nonsteroidal anti-inflammatory drugs (NSAIDS) including ibuprofen (MOTRIN)
  • Diclofenac (Voltaren) topical gel

Prescription Pain Relievers

  • Celebrex, Voltaren, and others

Orthobiologic injections

  • Platelet Rich Plasma (PRP)
  • Stem cell therapy

HA Injections

  • HA injections into the knee joint, such as MONOVISC High Molecular Weight Hyaluronan


MONOVISC is an FDA-approved therapy made from ultra-pure high molecular weight HS.  MONOVISC is a knee injection that supplements the joint fluid to provide cushioning, lubrication, and protection for the knee joint.

MONOVISC is indicated for the treatment of pain in OA of the knee in patients who have failed to respond adequately to conservative non-pharmacologic therapy and simple analgesics (e.g., acetaminophen).


  • FDA approved for the treatment of pain in OA of the knee
  • A non-avian sourced viscosupplementation derived from bacterial cells
  • Provides more HA to the joint than any other single HA injection
  • Administered in office under ultrasound guidance
  • Has been shown to provide pain relief for OA of the knee that lasts up to 6 months
  • Compared with a single treatment, there were no increased adverse events observed in a single repeat-injection study of MONOVISC.  The number of injections that is right for you is a decision you and I will make together.
  • Covered by Medicare and most commercial plans. Prior authorization may be required.

Call today to schedule an appointment to learn more about the best treatment options for you.