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8054 Yonge St. Thornhill. Just south of the intersection of Yonge and HWY 7/407

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Most services are covered by the Ontario Health Insurance Plan (OHIP)

Convenient Location

8054 Yonge St. Thornhill. Just south of the intersection of Yonge and HWY 7/407

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OHIP Covered Services

Most services are covered by the Ontario Health Insurance Plan (OHIP)


Anatomy of the knee joint

The knee is a large and complex joint that is formed by the joining of the lower end of the femur bone of the thigh, the upper ends of the tibia and fibula, or shin bones, and the patella, or kneecap.

The joint is supported by tendons, which attach muscle to bone and allow for movement in the joint, and ligaments, which attach bone to bone and stabilize the joint.

Two crescent-shaped pieces of cartilage sit between the femur and the tibia and provide protection and cushioning in the joint; these are called the medial and lateral menisci.

How does osteoarthritis develop in the knee joint?

Given the complexity of the knee joint and the high demand that is typically placed on it, it is prone to several types of injuries. Due to wear and tear, trauma or other forms of injury, or other causes, the protective cartilage in the knee joint can begin to wear down.

An unnoticed process

This process can often go unnoticed initially because there is no nervous tissue in the cartilage. Breakdown of the cartilage will result in reduced cushioning and increased friction in the joint as it moves, provoking further inflammatory changes.

Friction and chronic inflammation can also result in changes in the bones; bony overgrowth can result in the formation of bone spurs which then further increase friction in the joint and inflammation, causing a cyclic process that further damages the knee joint.

What are the symptoms?

Common symptoms of knee osteoarthritis include:

  • Pain with increased activity (such as stair climbing, walking, or standing from a seated position)

  • Tenderness or swelling in the knee joint

  • Stiffness or reduced range of motion in the knee, particularly upon waking

  • Cracking or crunching sounds in the knee joint with knee bending

How common is osteoarthritis of the knee joint?

According to WebMD, “more than 27 million people in the U.S. have osteoarthritis, with the knee being one of the most commonly affected areas” (Osteoarthritis of the knee, WebMD).

An article published in 2017 in the Proceedings of the National Academy of Sciences of the United States of America noted that “osteoarthritis (OA) is the most prevalent joint disease and a leading source of chronic pain and disability in the United States and other developed nations.

Knee OA accounts for more than 80% of the disease’s total burden and affects at least 19% of American adults aged 45 years and older” (Wallace et al. 2017).

A meta-analysis and systematic review article published on January 13, 2021, on the Rheumatology Advisor website reported that “based on study findings, the global prevalence of knee OA is 16% among individuals aged 15 years or over and 22.9% among those aged 40 years or over.

Further, approximately 654.1 million individuals worldwide had knee OA in 2020″ (Jacobs, 2021).

What are the risk factors associated with osteoarthritis of the knee joint?

Some common risk factors for osteoarthritis of the knee include:

  • Age

  • Activity level – repetitive movements like frequent squatting, kneeling, or heavy loads placed on the knee increase the risk

  • Excess weight/obesity

  • Family history of osteoarthritis

  • Gender – females are at higher risk of knee osteoarthritis

  • Previous injury to the knee

  • Other inflammatory conditions, such as rheumatoid arthritis

How is the condition diagnosed?

Diagnosis of knee osteoarthritis will involve several steps

1.- Initially, your physician will take a detailed medical history, noting any medical conditions you have, any medications you are taking, your lifestyle habits (such as diet, cigarette smoking, alcohol consumption, exercise habits, and more), and details pertaining to your knee pain; these details include when the symptoms began, what type of activities provoke pain, what reduces the pain, and how your symptoms affect your day-to-day functioning.

2.- Following a medical history interview, your physician will perform a physical examination, assessing for tenderness, heat, or swelling in the knee joint, pain provocation with specific movements, or visible/palpable deformities in the joint.

3.- Your doctor may also recommend that you have additional testing is done, such as an X-ray, which can assess for narrowing of the joint space or the formation of bone spurs, or an MRI, which can show tissue damage.

4.- Blood tests may also be recommended in order to rule out other possible causes of pain, such as rheumatoid arthritis.

How is the condition treated?

If you have been diagnosed with knee joint osteoarthritis, the approach best suited to your particular situation will depend on numerous factors, including your age, your activity level, the severity of pain, the degree of limitation you experience as a result of knee pain, and any other health conditions that you have.

Damage to the knee joint caused by osteoarthritis is, unfortunately, irreversible; however, there are multiple treatments and strategies for slowing or even halting further degeneration of the joint.

Some of these alternatives include:

  • Acetaminophen to reduce pain

  • NSAIDs (non-steroidal anti-inflammatory drugs) to reduce pain and inflammation

  • Other oral medications specific to treating arthritis and inflammation

  • Physiotherapy

  • Aquatics or pool therapy program

  • Acupuncture and Acupressure

  • Massage therapy

  • Occupational therapy (including improving the ergonomics of your workstation, if applicable)

  • Exercise to improve posture and gait and to reduce weight

  • Orthotics

  • Dietary changes to improve weight and reduce inflammation

  • Smoking cessation

What do we do at WMC?

At the Wilderman Medical Clinic, we offer a variety of interventional and non-interventional treatment options, including:

Interventional pain management for osteoarthritis of the knee joint:

  • Cortisone injections for knee joint osteoarthritis

  • Nerve block injections for knee joint osteoarthritis

  • Hyaluronic acid (viscous supplementation) injections for knee joint osteoarthritis

  • Dextrose (prolotherapy) injections for knee joint osteoarthritis

  • PRP (plasma-rich protein) injections for knee joint osteoarthritis

  • nStride injections for knee joint osteoarthritis

Non-interventional pain management for osteoarthritis of the knee joint:

  • Psychotherapy

  • Kinesiology education sessions

When is surgery required?

Several surgical options are available for the treatment of osteoarthritis of the knee

  • Arthroscopy can be used to remove or repair damaged pieces of cartilage in order to reduce pain and delay the need for more invasive surgery.
  • An osteotomy involves shaving off or removing a portion of bone to improve the alignment of the knee joint.
  • For severe knee joint osteoarthritis that is not adequately managed by other treatments, a joint replacement surgery may be recommended; this procedure involves the removal of the damaged joint, which is then replaced with a metal or plastic artificial joint.

Works Cited

Jacobs, Sheila. Assessing global health burden of knee osteoarthritis and modifiable risk factors. January 13, 2021. Rheumatology Advisor. Retrieved from

Wallace IJ, Worthington S, Felson DT, Jurmain RD, Wren KT, Maijanen H, Woods RJ, Lieberman DE. Knee osteoarthritis has doubled in prevalence since the mid-20th century. Proc Natl Acad Sci U S A. 2017 Aug 29;114(35):9332-9336. doi: 10.1073/pnas.1703856114. Epub 2017 Aug 14. PMID: 28808025; PMCID: PMC5584421.

Zelman, David. Osteoarthritis of the knee (degenerative arthritis of the knee). June 14, 2021. WebMD. Retrieved from


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