Knee Osteoarthritis stages 1, 2, 3, 4: Injections for knee joints
Does this happen to you?
Does one or both of your knees ache and stiffen sometimes, especially in the morning, but it goes away in half an hour?
Does the pain get worse at the end of the day or when you move your knee, and get better when you rest?
Can you feel the pain in the whole knee or just the front and sides?
Does it hurt more after going up or down stairs?
Doesthe pain sometimes wake you up at night?
Pain is likely to vary and you will have good days and bad days.
The effects of osteoarthritis can make you feel depressed or anxious, and can affect your social relationships and sleep.
If you have any of these problems, please contact us, as there are treatments that will help you recover your quality of life.
Take the first step towards a full and pain-free life with Regenerative Medicine.
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Knee osteoarthritis treatment specialist without surgery
I am Miguel Alfonso Porcar recognized specialist in the treatment of osteoarthritis of the knee and gonarthrosis with bioregenerative therapies of platelet-rich plasma, growth factors, autologous serum rich in cytokines…
At Regenerat Traumatology Clinic we are specialists in the diagnosis and treatment of the main ailments and knee injuries.
Our goal is to determine the cause of your knee pain, perform diagnostic tests and offer you the best treatment options to eliminate your pain and restore function.
Once the diagnosis is known, we will apply the most appropriate regenerative traumatology or orthopedic surgery treatment; hyaluronic acid injections, PRP, prolotherapy in the knee…, to relieve your pain and you can recover your well-being as soon as possible.
We want to help our patients using the safest, most successful and least invasive treatments possible!
English-Speaking Orthopedic Doctor for International Patients
Dr Carlos Mairal, an orthopedic surgeon and trauma specialist in regenerative medicine, provides medical care in English for international patients.
He specializes in the technique of ultrasound-guided infiltrations using platelet-rich plasma for the treatment of degenerative diseases such as patellar chondromalacia and osteoarthritis in knees, hips, shoulders, and other joints.
If you are looking for cutting-edge treatment for musculoskeletal injuries, osteoarthritis, or tendinopathies and prefer to communicate in English, Dr Mairal will offer you personalised care in a professional and welcoming environment.
Book your appointment today and receive expert care from an English-speaking orthopedic doctor.
What is knee osteoarthritis?
Knee osteoarthritis is a disease in which the cartilaginous material of this joint deteriorates due to wear and tear.
Cartilage stabilizes the knee and protects it against damage due to friction with the bone.
Cartilage reduction can lead to limited movement and severe pain.
Knee osteoarthritis is a very common disease present in 15% of people aged 50 to 54 years and for people aged 70 to 74 years, this proportion increases to 40%.
Osteoarthritis is often confused with arthritis in common parlance. Arthritis is a generic term for joint diseases related to inflammation.
These include, for example, infection-related arthritis and rheumatoid arthritis.
Occasionally, gonarthrosis can also cause inflammation, and in this case, it would also be called arthritis.
Causes of gonarthrosis – knee osteoarthrosis
In most cases, gonarthrosis is an age-related wear and tear of the cartilage in the knee joint that can lead to accumulation of fluid in the knee due to osteoarthritis. fluid accumulation in the knee due to osteoarthritis.
However, it may occur at an earlier age due to genetic predisposition or overloading of the knee.
In general, two types of osteoarthritis can be distinguished.
Primary and secondary osteoarthritis of the knee
Primary osteoarthritis is caused by a genetic predisposition.
Secondary osteoarthritis is due to external impact: injuries, misaligned legs (bent knees/bowed legs) or constant stress at work.
The causes of secondary gonarthrosis are:
- Obesity.
- Misalignment of the legs such as hooped knees or genu varum or genu valgus.
- Knee injuries such as a meniscus tear.
- Permanent stress in the daily routine.
- High-impact sports such as running, paddle tennis or soccer.
- Previous knee surgeries (meniscectomies).
The causes of gonarthrosis are very diverse. Sometimes, there is no specific reason, in which case we speak of idiopathic gonarthrosis.
What are the symptoms of osteoarthritis of the knee?
Gonarthrosis can manifest itself in many different ways.
Gonarthrosis usually manifests itself in the form of pain and limitation of movement of the knee joint, but the symptoms are not necessarily noticeable.
- In the early stages of the disease, those affected usually feel only mild pain when moving the knee. The pain usually disappears after a few steps.
- If gonarthrosis persists, all the cartilage material will have worn away and the bone ends, then unprotected, will rub against each other.
Symptoms may progress to persistent and severe pain, movement restrictions, loss of stability… and also lead to a knee joint effusion.
This pain may persist for a long time, and may not be directly related to movement.
Because symptoms can vary greatly, it is very difficult to determine progression.
While some patients never experience pain and suffer only minor movement restrictions, others may suffer severe pain and restrictions.
Others experience symptoms that disappear on their own after a period of time.
Gonarthrosis does not have to cause problems, even for a genetically predisposed person.
The decrease in knee joint cartilage due to osteoarthritis cannot be reversed.
However, the affected person can very effectively influence the rate of progression of the disease and the manifestation of symptoms.
Among other things, reducing obesity and staying physically active can strengthen the knee muscles and greatly slow the progression of the disease, thereby reducing movement restrictions and pain.
In addition, certain impact exercises performed in excess can worsen the symptoms of incipient osteoarthritis. However, it is good to walk for osteoarthritis of the knee, it is good to walk for osteoarthritis of the knee..
Diagnosis of osteoarthritis of the knee
Dr. Alfonso Porcar, expert in knee pathologies and injuries, diagnoses osteoarthritis of the knee.
- The initial evaluation is based on the patient’s medical history and physical examination or evaluation.
- Functional tests to check mobility and stability and reactions to pain through manual maneuvers directed by Dr. Miguel Alfonso.
- We can also use X-rays to examine the condition of the knee joint, and the cartilage in particular.
X-rays can clearly show significant wear damage.
Special attention is paid to the size of the joint space. The smaller it is, the more advanced the gonarthrosis.
Osteoarthritis Grades and Treatment: Stages of Knee Osteoarthritis and Their Management
There are 5 different degrees of severity of gonarthrosis. Let’s see what each degree consists of and the recommended treatments.
Grade 0 (No signs of gonarthrosis)
Grade 0 osteoarthritis of the knee refers to a normal joint with no signs of osteoarthritis.
This means that the cartilage, which is the tissue that cushions the ends of the bones within the joint, is in good condition, with no visible wear and tear, and that the functionality of the knee is as expected, with no pain, stiffness or limitations in movement.
It is recommended to maintain an active and healthy life to prevent the development of the disease.
Gonarthrosis Grade 1 (Mild) – Treatment
There is a minor narrowing of the joint space. There are small bony growths and hardly any cartilage damage. There may be no or very mild symptoms.
In this degree of osteoarthritis, lifestyle changes may be recommended, such as weight loss if necessary, low impact exercises to strengthen the muscles that support the knee, physiotherapy and occasional use of analgesics if pain is present.
Gonarthrosis Grade 2 (Moderate) – Treatment
Slight irregularities in the articular surface, increased bony growths and the space between the bones may begin to decrease slightly.
Symptoms such as pain or stiffness may be more evident, especially after periods of inactivity or excessive exercise.
We can use orthoses or insoles to improve alignment and weight distribution in the knee, as well as supplements such as glucosamine or chondroitin, although their effectiveness may vary from one person to another.
Gonarthrosis Grade 3 (Moderate to severe) – Treatment
Cartilage damage is evident, the space between the bones is further reduced and bone growths are larger.
Pain becomes more frequent and may interfere with daily activities.
In addition to the recommendations for grades 1 and 2, the use of infiltrations with hyaluronic acid or corticosteroids to relieve pain and inflammation, and further physiotherapy intervention is necessary.
Gonarthrosis Grade 4 (Severe) – Treatment
There is an almost total loss of cartilage, which means that there is bone to bone contact. We have a pronounced narrowing of the joint space and deformation/necrosis (bone cell death) in the joint parts.
This results in severe pain, swelling and a significant decrease in knee mobility.
In this advanced degree of gonarthrosis, options include:
- Intra-articular hyaluronic acid infiltrations.
- 1 monthly intra-articular platelet-rich plasma infiltration for 3 months.
- Intraosseous infiltration of platelet-rich plasma that can be combined with intra-articular PRP infiltrations.
When quality of life is greatly affected and none of the above options have been successful or the patient’s condition did not make them viable, surgery to replace the affected joint with a prosthesis(arthroplasty) is considered.
Injection for Knee Joints: Treatments for the Stages of Knee Osteoarthritis
Although there is no definitive definitive cure for osteoarthritis, there are several treatment options for gonarthrosis.
Knee joint cartilage detachment can be prevented conservatively through exercise and physical therapy.
Treatment of gonarthrosis grades 1 and 2: conservative treatment of knee osteoarthritis
– This primarily includes exercises to strengthen the protective and stabilizing muscles of the knee.
– Braces and inserts may also be used for support.
– Medications may also be used to relieve pain and prevent inflammation.
Treatment of gonarthrosis grade 3 and 4: Knee injections
Depending on the diagnosis, we can use different types of infiltrations.
From a dextrose solution that acts as a regenerative agent, through hyaluronic acid infiltrations, platelet-rich plasma, or Qrem, which is an autologous serum rich in cytokines.
Knee injections with PRP in Valencia, Spain
Intra-articular autologous PRP injections are more effective than hyaluronic acid injections in reducing pain and restoring joint function, especially in younger patients with knee osteoarthritis up to grade 3.
Due to its anti-inflammatory and analgesic effect, PRP reduces joint stiffness and slows down the progression of joint degeneration.
Treatment of grade 4 osteoarthritis with Intraosseous Infiltrations
For the treatment of severe knee osteoarthritis, it is advisable to perform intraosseous infiltration under sedation and radiographic control.
The combination of intraosseous and intra-articular infiltrations of PRP can improve the pain and functionality of the affected knee , delaying the need for arthroplasty.
Prolotherapy for lax knee ligament
A technique involving the injection of an irritant, usually a hypertonic dextrose solution, usually in the treatment of chronic painful musculoskeletal conditions.
Knee osteoarthritis, in addition to consisting of a loss of cartilage, causes distension or laxity of the knee ligaments.
We use prolotherapy as a coadjuvant treatment or in combination with platelet-rich plasma infiltrations.
Several studies have shown the ability to tighten and strengthen lax anterior cruciate ligaments, improving knee osteoarthritis.
ARCS treatment with autologous serum rich in cytokines
Autologous Cytokine Rich Serum can achieve up to 75% pain reduction for more than one year in osteoarthritis patients.
No medication and no side effects.
- QREM Cytokine contains cytokines, cell-released proteins and activators of the repair system.
- These substances guide the cells towards the regeneration process.
- Cytokines are a type of signaling molecules used in cellular communication and enhance healing in those cases where the tissue is in worse condition.
- The cytokine-rich serum promotes decreased inflammation and activates cartilage repair.
Hyaluronic acid for knee osteoarthritis
Intra-articular injection of hyaluronic acid restores the properties of the synovial fluid, protecting the arthritic joint from deterioration.
Its use is indicated in patients with osteoarthritis or degenerative changes of the cartilage, delaying its evolution and even the need for a joint prosthesis.
Orthopedic surgery
If the amount of cartilage in the knee joint has already decreased significantly, surgery is another way to slow the progression of gonarthrosis and counteract its symptoms.
Surgical treatments, such as the implantation of a knee prosthesis or bone correction (osteotomy) in deformed legs, are complex and should only be considered if conservative and orthobiological therapies have not been successful and the pain is persistent and very severe.
Knee prosthesis – Arthroplasty
It is one of the most frequent surgical treatments that we perform in Regenerat clinic. Always in cases of severe osteoarthritis of the knee and when all conservative treatments have failed.
It is also called total knee arthroplasty and we usually place a femoral, a tibial and a patellar component, with a plastic or high density polyethylene utra.
We use the most modern surgical and anesthetic techniques, so the result of our knee prostheses is very satisfactory in terms of improvement of pain and return to normal life.
Rehabilitation
Rehabilitation of gonarthrosis is a key phase of treatment. It is crucial for restoring knee function and relieving symptoms.
Comprehensive physiotherapy is not only essential in the conservative treatment of gonarthrosis, but also after surgery. The weakened knee must be slowly readapted by means of adapted exercises.
Additional electrotherapy can accelerate the healing process. Functional electrical stimulation helps rebuild muscles weakened by osteoarthritis.
Why Regenerat Clinic to treat your osteoarthritis – knee gonarthrosis in Valencia?
Knee pain referents in Valencia
In the field of treatment of knee pain and pathologies, Regenerat clinic is your reference center.
State-of-the-art technology
Ultrasound-guided ultrasound scanners that facilitate diagnosis. Alternative treatments to knee prosthesis, less invasive that relieve and in many cases eliminate your knee pain in Valencia, offering better health and quality of life.
Opinions on treatment of osteoarthritis of the knee with injections
Our patients value our experience and multidisciplinary treatment and care after infiltrations with hyaluronic acid or PRP for knee gonarthrosis, eliminating pain and recovering your activity after treatment.
We provide solutions that are not found in other clinics and hospitals, through regenerative treatments for knee pain, which in many cases avoid the need for surgery.
You can watch videos with patient’s opinions about the treatment, as well as opinions about plasma infiltrations.
Other pathologies treated by a knee orthopedic surgeon
Causes related to knee injuries include damage to parts of the knee, such as bones, cartilage, ligaments, tendons or muscles.
- Knee tendonitis treatment:Patellar tendonitis results from inflammation of the tendon that connects the patella (kneecap) to the tibia (shinbone). It is commonly referred to as jumper’s knee, but not runner’s knee.
- Injections for knee bursitis: Bursitis is the inflammation of the fluid-filled sacs, or bursae, that cushion the knee. It is often caused by repetitive movements, pressure, or injury and is not typically a direct consequence of tendinitis.
- Arthritis: occurs when joint cartilage wears away and causes pain, stiffness and swelling.
- Chondromalacia patellae: is the softening and loss of cartilage in the kneecap. It occurs in young and adult athletes suffering from knee arthritis.
- Bone edema of the knee: Inflammation or injury in the medullary zone of the knee, due to a contusion, with the appearance of microfracture and inflammation.
- Sprained knee ligaments: Are usually due to sports injuries.
- Treatment for torn meniscus injuries: Meniscus tears are common among athletes and those involved in contact sports. In older individuals, degenerative meniscus tears are more prevalent.
New opening Regenerat: Orthopedic surgeon in Gandía, Benidorm, Denia, Jávea, Calpe, Altea, La Nucia….
Specialists in Regenerative Medicine and Physiotherapy in Gandía
Call ☎ 961 146 834
Regenerat is a paediatric and adult trauma clinic, specialising in regenerative medicine treatments that delay and, in many cases, avoid orthopaedic surgery.
Our patients get an unbiased diagnosis and we offer you various surgical and non-surgical treatment options.
The most common pathologies treated at our medical center are osteoarthritis, back pain, tendon injuries, and sports injuries.
English-Speaking Orthopedic Doctor for International Patients
Serving patients from Gandia to Benidorm, including Dénia, Jávea, Altea, Calpe, La Nucía, and across Alicante: Expert care at our Gandia clinic.
We are located at C/ Ciutat de Laval, 23, 46702 Gandia, Valencia, Spain.
Make an appointment in Gandia, Catarroja or Torrent
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Contact information
☎ 961 146 834
info@regeneratclinica.com
Schedule
Mornings – 9:30am – 14:00pm
Afternoons – 16:00pm – 20:00pm
Saturday & Sunday – Closed
Regenerat Clinic in Catarroja
Carrer Emili Ferrer Gómez, 4, 46470
Regenerat Clinic in Torrent
C/ del Mestre Lorenzo Fuertes Julvez, 14, 46901
Regenerat Clinic in Gandia
C/ Ciutat de Laval, 23, 46702 Gandia, Valencia
