A Seoul orthopaedic surgeon explains the four commonly used knee osteoarthritis stages, treatment options at each stage and why MRI findings and symptoms matter.
A Seoul orthopedic surgeon explains why knowing your stage is the first step — and why it is only a starting point
SEOUL, South Korea — October, 2026 — On World Arthritis Day, many people with aching knees are asking the same question: what can I actually do about it? The answer often depends on how far the arthritis has progressed.
Knee osteoarthritis is usually graded from 1 to 4 on a standing X-ray. The grade does not decide treatment on its own, but it helps frame which options are worth discussing, says Yeong Seok Lee, M.D., Ph.D., an orthopedic surgeon at St. Luke's Hospital in Seoul.
Here is how the stages are commonly described, and the treatments doctors often consider at each one:
| Stage | What an X-ray typically shows | Options often discussed |
| 1 — Early | Possible small bone spurs; joint space still normal | Exercise, weight management, activity changes |
| 2 — Mild | Clear bone spurs; joint space may begin to narrow | The above, plus physical therapy, pain medication, bracing; injections in some cases |
| 3 — Moderate | Clearly narrowed joint space and several bone spurs | The above; for selected patients with localized cartilage damage, arthroscopic repair or options such as bone marrow injection or CARTISTEM® may be discussed |
| 4 — Severe | Little joint space left ("bone-on-bone"), large bone spurs | Partial or total knee replacement; realignment surgery in selected cases |
Exercise and weight management remain the foundation at every stage, including after surgery.
"The grade on an X-ray is a starting point, not a verdict," said Dr. Lee. "Two people with the same grade can feel very different. The right plan depends on where the damage is, how the knee is aligned and what the patient wants to get back to."
An X-ray shows bones and the space between them, but not the cartilage, meniscus or ligaments directly. That is why an MRI is often the next step before deciding on a procedure.
At St. Luke's Hospital, one orthopedic team reviews symptoms, imaging, knee alignment and cartilage condition before discussing any single treatment. MRI is performed on site and read by a full-time radiologist. Because the hospital offers the full range — from rehabilitation and injections to cartilage procedures and joint replacement — the recommendation can be based on the knee rather than on one procedure.
"On World Arthritis Day, my message is simple," Dr. Lee said. "Keep moving, and get an accurate picture of your knee before making a big decision."
Patients in the United States can send recent X-rays or MRI images for a review from home through international.slmc.co.kr/medical-review. The team replies in English within three business days, and consultations are held directly in English with Dr. Lee.
Regulatory note: CARTISTEM® is approved for specific uses in South Korea. It is not FDA-approved for commercial use in the United States. Treatment suitability, expected benefits, limitations, risks, and alternatives should be reviewed individually.
Next in the series (October 20): What a knee MRI shows that an X-ray cannot.
About Yeong Seok Lee, M.D., Ph.D. Dr. Lee is an orthopedic surgeon focused on knee and shoulder care and a Clinical Professor at Sungkyunkwan University School of Medicine (Samsung Medical Center). His research has appeared in The American Journal of Sports Medicine and the Journal of Shoulder and Elbow Surgery.
About St. Luke's Hospital. St. Luke's Hospital is a multi-specialty hospital in Seoul, open 365 days a year, with full-time radiology and anesthesiology specialists on staff, and about an hour from Incheon International Airport. Its Stem Cell & Joint Preservation Center offers knee care ranging from injections to cartilage procedures and joint replacement. international.slmc.co.kr
Media contact: International Team, St. Luke's Hospital · [email protected]
This release is for general information and is not medical advice. Individual results vary.
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