The Kellgren-Lawrence grading system is radiological classification of knee osteoarthritis. It is based on x- rays and consists of normal, Grade I, Grade II, Grade II and Grade IV.
This categorical scale incorporates important radiographic features of osteoarthritis:
- Joint space narrowing – bone is visible on x-ray but the articular cartilage that covers it is not. A normal joint therefore appears to have a space between the bones. Any decrease in space implies a reduction in cartilage cover.
- Osteophytes - small bony projections that from around joint margins.They are responsible for limiting range of motion and can cause pain.
- Sclerosis – this means ‘hardening’ and is a sign of osteoarthritis, seen as increased white areas in the bone at the joint margins
Grade II: Small osteophytes, possible narrowing of the joint
Grade III: Multiple, moderately sized osteophytes, definite joint space narrowing, some sclerotic areas, possible deformation of bone ends
Grade IV: Multiple large osteophytes, severe joint space narrowing, marked sclerosis and definite bony end deformity.
Knee x-rays and Kellgren-Lawrence Classification is used to determine candidacy for knee replacement. Stem cell therapy is an alternative to total knee replacement. Research shows that more than 1 in 10 patients after knee replacement had chronic pain in the knee cap area. A more recent study found that 44% of patients continued to experience pain 3-4 years post knee replacement. All too often the source of the pain is the lower back and not the knee.