Kellgren Lawrence Classification For Knee Osteoarthritis

Last Updated on May 18, 2024

The Kellgren Lawrence grading system is a radiological classification of knee osteoarthritis. It progresses from grade 0 to grade IV and based on x-rays.

Knee osteoarthritis is a very common problem prevalent in all sections of society. While most of the changes are related to age, weight is a modifiable factor.

Grading of knee osteoarthritis is needed to gauge the severity of the disease, communication with colleagues and planning for the treatment.

There are a number of grading systems devised for knee osteoarthritis, the Kellgren-Lawrence grading scheme is the most widely used and accepted standard for diagnosis of osteoarthritis of the knee.

Grade 0

No radiographic features of osteoarthritis are present.

Grade I

There is a doubtful narrowing of joint space narrowing [ A normal joint, therefore, appears to have a space between the bones. Any decrease in space implies a reduction in cartilage cover.] and possible osteophytes[small bony projections that from around joint margins. They are responsible for limiting the range of motion and can cause pain.]

Grade II

There is the presence of osteophytes and possible joint space narrowing on the anteroposterior weight-bearing radiograph.

[weight bearing radiographs imply X-rays taken while the person stands on both the feet. A nonweight bearing x-ray is taken when a person is lying down and thus not bearing weight on knees]

Grade III

Grade III Kellgren Lawrence is characterized by multiple osteophytes, definite joint space narrowing, sclerosis [seen as increased white areas in the bone at the joint margin] and possible bony deformity.

Grade IV

It is characterized by large osteophytes, marked joint space narrowing, severe sclerosis, and definitely bony deformity.

Criticism of Kellgren Lawrence grading scheme

The Kellgren Lawrence grading scheme has been criticized for characterizing the progression of osteoarthritis of the knee as a linear process and combining osteophyte and joint space narrowing measurements because they could also develop independently of itself.

About Dr Arun Pal Singh

Arun Pal Singh is an orthopedic and trauma surgeon, founder and chief editor of this website. He works in Kanwar Bone and Spine Clinic, Dasuya, Hoshiarpur, Punjab.

This website is an effort to educate and support people and medical personnel on orthopedic issues and musculoskeletal health.

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