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As the population ages there is an increasing concern amongst the population about the aging knee. Osteoarthritis as it iscalled affects population without distinction of caste,creed,nationality and gender. Understanding the pathogenesis of this debilitating disease would certainly help in the proper management. Diagnosis is usually never an issue as it can be diagnosed by the cardinal signs of chronic pain, stiffness, crepitations and varus deformities. Radiologically one finds decrease in joint space, osteophytes, subchondral sclerosis, subchondral cysts, loose bodies amongst others. Comprehensive medical research globally points out to various newer mechanisms in the synthesis of pain in OA knee. The treatment options are very many ranging from reassuance till complex replacement surgeries which are so common these days. A comprehensive discussion of various pathogenesis theories are discussed and newer concepts of medical management are suggested keeping the patients compliance as one of the important parameters. These deliberations should lead to further research in various conservative management options for this debilitating condition.

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Prof Gourishankar Patnaik is a trained orthopedic and spinal surgeon from India. A gold medallist, he was untill recently professor and HOD Orthopedics at the Melaka Manipal Medical college, Malaysia. Philosophy, Religion and Languages are his other interest. A gifted surgeon, his research interests include osteoarthritis and spinal cord regeneration.

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