Knee Osteoarthritis

About Knee Osteoarthritis

Osteoarthritis (OA) is a term used to describe degenerative joint disease resulting from progressive loss of cartilage, the protective tissue that covers the ends of bones and allows them to glide without friction. In the later stages of knee OA, reduced lubrication from synovial fluid contributes to further degeneration of the joint.

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Osteoarthritis of the knee has been traditionally associated with wear and tear in older adults, but it is increasingly common in younger sedentary obese populations. In fact, recent clinical evidence suggests that osteoarthritis is both preventable and reversible, and that the pain associated with osteoarthritis is not directly caused by lost cartilage, but by sympathetic nerves that sprout in damaged synovial tissue, and in the skin that covers the arthritic joint.

Healthy Knee
Knee Osteoarthritis

Symptoms of Knee Osteoarthritis

Osteoarthritis is a progressive disease that worsens gradually over time. In the early stages, you may experience no symptoms at all. As the disease progresses, symptoms become more noticeable, and may become debilitating in the later stages.

Knee OA Symptoms include:

  • Pain during physical activity
  • Intense pain first thing in the morning, or following prolonged inactivity
  • Inflammation and redness, with the joint feeling warm to the touch
  • Tenderness around the knee joint
  • Knee locking or buckling
  • Popping or crackling in the joint
  • Stiffness and reduced range of motion
  • Reduced joint space when viewed on imaging results

Diagnosis of Knee Osteoarthritis


Initial diagnosis of knee OA is based on symptoms and medical history, followed by a physical exam. Your doctor may also order diagnostic tests, such as x-rays or blood tests.

At NYDNRehab, we use high-resolution diagnostic ultrasonography to view the knee joint in motion, in real time. Coupled with patient feedback during the procedure, real-time ultrasound gives us a vivid image of the nature and severity of your knee OA.


Explore more advanced diagnostic tools available only at NYDNRehab:


Knee Osteoarthritis Treatment

There are a number of treatments available to address knee OA, each with its benefits and limitations. However, it is universally agreed that regular exercise and lifestyle modification are key to preventing, stopping and reversing knee OA.

Popular treatment options include:
  • Physical therapy exercises and stretches to strengthen and balance the structures supporting the knee
  • Weight loss to reduce joint loading
  • NSAIDs and topical analgesics to reduce pain and inflammation
  • Wraps and braces to provide additional joint support

At NYDNRehab, we have taken knee osteoarthritis treatment to a whole new level, with a one-of-a-kind conservative knee osteoarthritis treatment center unlike any other in the United States. We believe you can live and move with knee osteoarthritis, without pain and discomfort, and avoid or postpone surgery.

With our unique collection of innovative technologies and high resolution musculoskeletal ultrasound, we have created a unique, individualized approach to treatment, based on careful metabolic and gait analysis, and neuromuscular control testing. With innovative therapies, advanced technologies and regenerative injection therapy under one roof, the NYDNRehab clinic is unrivaled in the United States for knee OA treatment.

Knee Osteoarthritis Physical Therapy in NYC

At NYDNRehab, we take a holistic approach to treating knee OA. Our knee pain specialists have access to some of the most advanced and innovative technologies and treatment methods in the country. Our patients are carefully tested and examined, and we are able to create an individualized treatment plan based on each patient’s unique profile.

Our unique ground-breaking technologies include:

Diagnostic ultrasonography
Diagnostic ultrasonography
SMI and Sonoelastography
SMI and Sonoelastography
DD Robotech
DD Robotech
C.A.R.E.N. (computer assisted rehabilitation environment)
C.A.R.E.N. (computer assisted rehabilitation environment)
Fully instrumented 3D gait analysis
Fully instrumented 3D gait analysis

Our unique multifaceted individualized approaches include:

KINEO Intelligent Load

Strengthening can be performed without risk of overloading in the viscous mode

3D Gait retraining with C.A.R.E.N

Оur virtual reality feedback environment

Ground breaking technology
Ground breaking technology

Ground breaking technology to restore coordination, balance and gait (walking) patterns


AlterG anti-gravity treadmill to improve circulation and range of motion while unloading the knee

DD Robotech

DD Robotech neuromotor retraining with artificial intelligence to restore brain-muscle neuromotor control

Hyaluronic acid injections
Hyaluronic acid injections

Hyaluronic acid injections (viscosupplementation) to improve shock absorption and enhance joint lubrication


Extracorporeal shockwave therapy to reduce friction between ligaments and osteophytes, improve circulation, denervate small nerves and promote cartilage repair

Ultrasound guided dry needling

Ultrasound guided dry needling and acupuncture to reduce pain, release trigger points and promote healing

Genicular nerve block treatment
Genicular nerve block treatment

Genicular nerve block treatment to temporarily block knee pain while your muscle strength and movement control improve


Online physical therapy from the comfort of your home or office

Chiropractic in NYC

If you suffer from chronic knee pain, don’t waste your time and money on one-size-fits-all therapies and surgeries that fall short of resolving your problem. Contact us today, and get rid of your knee pain so you can enjoy being active again.


Contact us today, and get rid of your knee pain so you can enjoy being active again.

Physical Therapy Treatments at Nydnrehab

Our Rewards

Lev Kalika Clinical Director and DC, RMSK

Dr.Kalika has revolutionized knee osteoarthritis care by using high resolution diagnostic ultrasonography for structural diagnosis, combined with gait and motion analysis technology. The NYDNRehab motion and gait analysis lab is the only private lab in the US to feature research-grade technologies found only in the world’s top research labs, and made available to patients in our private clinic. Dr.Kalika’s modern approach to knee osteoarthritis has put him on the radar of some of the world’s top distance runners, pro athletes and professional ballet dancers.

Our Specialists

HyunJu YOO, PT, MPT, DPT, CPI (Licensed Physical Therapist)
Dr. Christina Pekar DC
Dr. Michelle Agyakwah DC
Mariam Kodsy Physical Therapist

In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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