Stemcelldoc's Weblog

November 13, 2011

Kellgren-Lawrence Classification: Knee Osteoarthritis Classification and Treatment Options

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 I : Unlikely narrowing of the joint space, possible osteophytes

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.

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