Knee Osteoarthritis
Osteoarthritis Knee Joint Treatment That Finds the Root Cause
Stairs that used to be nothing. A garden you stopped kneeling in. A walk you keep cutting short. Knee arthritis takes these away slowly, and most treatment only quiets the ache for a few weeks. Dr. Ilana Etelzon finds what is actually driving your knee pain and treats that, so you can get back to what you love without rushing into surgery.
Double Board-Certified
Regenexx-Certified Provider
Ultrasound & X-Ray Guided
4 Offices in NY & NJ
Why it still hurts
Two knees with the same X-ray can feel completely different
Osteoarthritis is the gradual wearing down of the cartilage that cushions the knee joint. It is the most common form of arthritis, and some degree of it shows up on most knee X-rays after age 50. What most people never hear is this: the amount of wear on your X-ray does a poor job of predicting how much your knee hurts. Research has found that plenty of people with significant wear on imaging have little pain, while others with mild wear hurt every day.
That gap matters. Cartilage has no nerve endings, so the pain you feel comes from the structures around it: the bone underneath, the lining of the joint, the ligaments, the meniscus, and the muscles that control the knee. Treatment aimed only at the cartilage, or only at the pain signal, misses the part that keeps you sore.
Pain that keeps coming back has a reason. Finding it comes first.
The root causes
Six things that drive knee arthritis pain
Most painful arthritic knees have more than one of these at work at the same time. That is why a single shot rarely settles things for long, and why your plan should match your own mix.
1
Worn cartilage
The cushioning surface thins and roughens, so the joint spreads load less evenly. This sets the stage for everything else on this list.
2
Stressed bone under the cartilage
As cartilage thins, the bone beneath it takes more force and can develop bone marrow lesions, areas of swelling visible on MRI. Studies link these lesions closely to arthritis pain, and an X-ray cannot show them.
3
An inflamed joint lining
The synovium, the lining of the joint, can become irritated and swollen. It produces extra fluid and that stiff, puffy feeling after activity.
4
Loose ligaments
Stretched or weakened ligaments let the knee shift slightly with each step. That small instability grinds on the joint and keeps irritating the same tissue.
5
A worn meniscus
The meniscus is the knee's shock absorber. Degenerative tears are common alongside arthritis and can cause catching and pain along the joint line.
6
Weak muscles and poor alignment
When the thigh and hip muscles fall behind, or the kneecap tracks off center, the joint absorbs forces the muscles should be handling.
Step one: Reveal
How Dr. Etelzon finds what is driving your pain
Your first visit is built around one question: what is keeping this knee from settling down? Dr. Etelzon answers it with the same careful steps every time.
- Your storyWhen it started, what makes it worse, what you have already tried, and what you want to get back to.
- A hands-on examShe checks ligament stability, the meniscus, swelling, range of motion, and how your hip and ankle move above and below the knee.
- Ultrasound in the roomIn-office ultrasound shows fluid, inflamed tissue, and ligament damage in real time, while you move.
- Your imaging, read closelyShe reviews your X-ray and, when needed, your MRI, which can show the bone marrow lesions and meniscus tears an X-ray misses.
You leave knowing which drivers are at work in your knee and what each part of your plan is for.
Reveal
Find every driver
Diagnose all the sources of pain before treating any of them.
Repair
Treat the tissue
Image-guided regenerative care aimed at the damaged structures.
Restore
Rebuild control
Strength and movement work so the knee holds up under load.
Renew
Get back to life
Return to your activities and keep the knee there.
Step two: Repair
Treatment matched to what is actually wrong
Once the drivers are clear, Dr. Etelzon chooses treatments that aim at them directly. Every injection is placed under ultrasound or X-ray guidance, so it reaches the exact tissue that needs it.
PRP Injections
Concentrated platelets from your own blood, used to calm an inflamed joint and support irritated ligaments and tendons around the knee. Often a strong fit for mild to moderate arthritis.
Learn about PRP injections ›Bone Marrow Concentrate
Cells drawn from your own bone marrow, used for more advanced arthritis and for bone marrow lesions in the bone beneath the cartilage.
Learn about stem cell injections ›Regenexx Protocols
Dr. Etelzon is a certified Regenexx provider, so your injections follow tested, standardized protocols used across a national network of physicians.
Learn about Regenexx ›MLS Laser Therapy
A focused laser that reduces inflammation and pain. It is often paired with injections to help an irritated knee settle faster.
Learn about MLS laser therapy ›Shockwave Therapy
Acoustic waves that boost blood flow to stubborn tendon pain around the knee, such as the patellar tendon just below the kneecap.
Learn about shockwave therapy ›Strength and Movement Plan
Targeted exercises that rebuild the muscles controlling your knee and correct how it tracks, so the repair holds up once you are active again.
See our regenerative approach ›Where cortisone and gel shots fit
Cortisone can calm a flare for a few weeks, and it has a place. Repeated cortisone injections have been linked to faster cartilage loss in a randomized trial, so Dr. Etelzon uses them sparingly. Hyaluronic acid, or gel, injections help some patients and do little for others. She will tell you plainly which options make sense for your knee.
Every stage
What can help at each stage of knee arthritis
Knee osteoarthritis is graded from 1 to 4 based on imaging. The grade guides the plan, and your drivers decide it. Read more about the four stages of osteoarthritis.
Grades 1 to 2
Early arthritis
Mild wear with pain that comes and goes. This is the best window to act. PRP, laser therapy, and a strength plan often calm the knee and break the cycle of flare-ups.
Grade 3
Moderate arthritis
Clear cartilage loss, more frequent pain, and sometimes swelling. PRP and bone marrow concentrate aimed at the specific drivers can reduce pain and improve function for many patients.
Grade 4
Advanced, bone-on-bone
Severe wear. Some bone-on-bone knees still respond well, especially when bone marrow lesions or instability drive the pain. When a knee replacement is the better choice, Dr. Etelzon will tell you so.
An honest note. Injections cannot regrow a fully worn joint surface. The goal of regenerative care is less pain, better function, and more years with your own knee.
Results
Outcomes tracked across the Regenexx network
Regenexx collects patient-reported outcomes from certified clinics, including knee procedures. Explore the live results below.
Like all medical procedures, regenerative procedures have a success and failure rate. Individual results vary.
Step four: Renew
Back to the things your knees are for
Patients come to us wanting specific things back: kneeling in the garden, hiking a trail with a partner, taking stairs without planning around them, getting down on the floor with the grandkids. That is what we treat toward.
Kneeling in the garden again
Back on the trail
Your first visit
What to expect, and what it costs
Your first visit is a consultation with Dr. Etelzon: your history, a hands-on exam, ultrasound, and a review of your imaging. Bring any knee X-rays or MRIs you have. If treatment makes sense, you leave with a written plan and a clear price before anything is scheduled.
Most regenerative procedures, including PRP and bone marrow concentrate, are not covered by insurance. Many patients use HSA or FSA funds, and monthly financing is available. See our payment and financing options.
Find us
Knee osteoarthritis treatment across New York and New Jersey
Dr. Etelzon and her team treat knee arthritis at four offices, so care is close to where you live and work.
New York
Brooklyn
2577 East 17th Street, 1st Floor Unit 18B, Brooklyn, NY 11235Brooklyn office › New JerseyClifton
1111 Paulison Ave, Unit 2, Clifton, NJ 07011Clifton office › New JerseyNewark
73-75 Ferry St, Newark, NJ 07105Newark office › New JerseyPerth Amboy
345 State St, Unit B, Perth Amboy, NJ 08861Perth Amboy office ›Call 1 (844) 959-7246 to reach any office.
Keep reading
More on knee pain and regenerative care
References
- Bedson J, Croft PR. The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature. BMC Musculoskeletal Disorders. 2008;9:116.
- Felson DT, et al. The association of bone marrow lesions with pain in knee osteoarthritis. Annals of Internal Medicine. 2001;134(7):541-549.
- McAlindon TE, et al. Effect of intra-articular triamcinolone vs saline on knee cartilage volume and pain in patients with knee osteoarthritis: a randomized clinical trial. JAMA. 2017;317(19):1967-1975.
- Belk JW, et al. Platelet-rich plasma versus hyaluronic acid for knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. American Journal of Sports Medicine. 2021;49(1):249-260.
- Centeno C, et al. Efficacy of autologous bone marrow concentrate for knee osteoarthritis with and without adipose graft. BioMed Research International. 2014;2014:370621.
Find out what is driving your knee pain
One visit, a clear answer, and a plan built around your knee and the life you want back. This is where the trying stops.