Knee osteoarthritis progresses gradually over time. Early recognition of each stage helps patients choose appropriate treatment options.

• Stage 1: The cartilage is slightly worn, causing little or no pain. However, bone spurs may begin to form, leading to discomfort when bending or extending the knee. Patients should maintain regular exercise to reduce symptoms and slow disease progression.
• Stage 2: Bone spurs become more noticeable, but the joint space has not significantly narrowed. The joint still functions normally due to sufficient lubrication. Patients may start to feel pain while walking or running and experience stiffness after prolonged sitting. Recommendation: Maintain a healthy weight and avoid kneeling, squatting, or jumping.
• Stage 3: The joint space narrows, cartilage wears down significantly, and bone spurs develop further. Morning stiffness, swelling, and pain around the knee may appear, possibly accompanied by inflammation. Stronger pain medication is often required, but long-term overuse should be avoided.
• Stage 4: Cartilage is almost completely lost, the joint space becomes rigid, bone ends are deformed, and numerous bone spurs form. Patients experience severe pain and difficulty walking or performing daily activities. At this stage, joint replacement surgery is often the only effective treatment option.

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