Knee Osteoarthritis

Osteoarthritis of the knee is a common condition that mostly affects adults over age 50, although it can strike at any age. The condition is marked by the wearing away of cartilage, the protective cushion that prevents your bones from making contact with one another as you move. In the later stages of knee OA, reduced lubrication from synovial fluid contributes to further degeneration of the joint.

Because osteoarthritis tends to affect older people, it was once assumed to be an inevitable consequence of aging, brought on by wear and tear over time. However, recent clinical evidence shows that osteoarthritis is both preventable and reversible. Moreover, new research indicates that the pain associated with osteoarthritis is not directly caused by lost cartilage, but by sympathetic nerves that sprout in damaged synovial tissue and the skin covering the arthritic joint.

Knee Osteoarthritis Symptoms

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.

Symptoms of knee OA include:

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

Knee Osteoarthritis Diagnosis

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 NYDNR, 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.

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 is 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

Knee Osteoarthritis Physical Therapy in NYC

At NYDNR, we take a multifactorial comprehensive 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 screened and examined so we are able to create an individualized treatment plan based on each patient’s unique profile.

In addition to some of the popular treatments mentioned above, we offer a variety of innovative solutions to treat knee OA, including:

AlterG treadmill therapy

to improve circulation while unloading the knee

APOS therapy

to modify gait and realign the knee joint

Hyaluronic acid injections

(viscosupplementation) to improve shock absorption and enhance joint lubrication

ESWT (extracorporeal shockwave therapy)

to reduce friction of ligaments against osteophytes, improve circulation, denervate small nerves and promote cartilage repair

Ultrasound guided dry needling and acupuncture

to reduce pain and promote healing

Genicular nerve block treatment

to temporarily block knee pain while your joint heals

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.

130 West 42 Street Suite 1055, New York NY 10036

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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