Kellgren-Lawrence Grading for Knee Osteoarthritis

Created by:

21 May 2017 - General

photo from Medical News Today

The Kellgren-Lawrence radiologic grading system is the most common system used to classify knee osteoarhtritis. It consists of 5 grades that serves as a guide for appropriate management. The grading sytem is as follows:

  • Grade 0
    • No radiographic findings of osteoarthritis
  • Grade 1
    • Doubtful joint space narrowing
    • Possible osteohpytes without clinical significance
  • Grade 2
    • Possible joint space narrowing
    • Definite osteophytes 
  • Grade 3
    • Moderate joint space narrowing
    • Definite osteophytes
    • Some bony sclerosis
  • Grade 4
    • Severe joint space narrowing
    • Definite osteophytes
    • Subchondral sclerosis
    •  Definite deformity of bone contour 

+ Note that symptoms can occur without radiographic evidence; hence, a Grading of 0 is included

Grades 0-2 warrant non-surgical management such as physical therapy, pain medications, and steroid, platelet-rich plasma, and hyaluronic acid injection.

Grades 3-4 warrant referral to an orthopedic surgeon for possible surgical intervention