Knee osteoarthritis is not an event; it is a slope. Between the first ache on the stairs and the day a surgeon recommends a replacement lie years — often a decade or more — and what you do during those years decides how steep the slope is. This page is about that interval, because it is where most arthritic knees in Kolkata live, and where the most preventable mistakes are made.
Dr. Pradyumna Chakraverty, MS Orthopaedics (KPC Medical College, Jadavpur) and Assistant Professor of Orthopaedics, treats knee arthritis across its full spectrum at his Behala and South Kolkata clinics — and because he performs knee replacement himself, his advice on avoiding one carries no conflict: he has nothing to sell you that your knee does not need.
The cartilage cushioning the joint thins and frays, the bone beneath it reacts and hardens, and the joint lining becomes irritable — swelling after exertion, stiffening after rest. In Kolkata's clinics the pattern skews towards the inner compartment of the knee, aggravated by decades of floor sitting, deep squatting and, frequently, body weight the joint was never asked to carry in youth. Genetics deals the hand; load and muscle decide how it is played.
Stage one: muscle and weight. The quadriceps is the knee's shock absorber. Strengthen it and pain drops — this is the most consistently proven treatment in the whole field, and the most neglected because it is free and requires effort. Alongside it, weight: each kilogram lost is several kilograms of load removed from the knee with every step. These two interventions outperform any tablet.
Stage two: sensible medication. Paracetamol and short courses of anti-inflammatories for flares, used deliberately rather than as a daily habit — long-term unsupervised painkiller use damages kidneys and stomachs while the knee quietly worsens. Supplements such as glucosamine are discussed honestly: the evidence is thin, and Dr. Chakraverty will say so.
Stage three: injections, selectively. A corticosteroid injection can break a stubborn flare; viscosupplementation suits selected moderate-stage knees. Neither rebuilds cartilage, and a knee that needs injection after injection is telling you something the injections cannot fix.
Stage four: surgery. When the joint surface is gone and life has narrowed despite honest effort at the stages above, replacement — partial or total — is the reliable way back to walking without fear. That conversation belongs on the knee replacement page.
Worn cartilage does not grow back — but arthritis can often be managed so well that surgery is postponed for years or avoided. Muscle, weight and sensible activity change its course.
Good, within comfort. What aggravates arthritic knees is deep squatting, long stair climbing and prolonged cross-legged sitting.
Steroid injections can settle a flare; lubricant injections help selected moderate knees. They are a bridge within a wider plan, not a cure.
Painless clicking is common and usually harmless. Clicking with pain, swelling or catching deserves examination.
When pain limits daily walking or sleep despite genuine effort at exercise, weight management and medication — at that point the surgical conversation is realism, not defeat.
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