If you have been told by your doctor that your knee is bone-on-bone, you may be wondering what this means for you. Bone on bone indicates that the knee joint has lost its articular cartilage and there is no cushion between the bones. This can lead to bone-knee pain and stiffness in the knee.

In this blog post, we will discuss the causes of knee joint degeneration and possible treatment options.

The Knee

The knee is the largest joint in the human body and is made up of three bones: the femur (thighbone), tibia (shinbone), and patella (kneecap). The knee joint space is held together by ligaments, which are strong bands of tissue that connect the bones. The knee also has a layer of cartilage, called articular cartilage, which covers the ends of the bones and acts as a cushion.

Knee Pain Causes

There are several reasons why the knee joint may degenerate. One common cause is osteoarthritis of the knee. Osteoarthritis is a common type of arthritis that causes the cartilage in the joints to break down. This can be caused by age, injury, or obesity. Other conditions that may lead to knee joint degeneration or knee arthritis include an autoimmune disease like rheumatoid arthritis.

Besides conditions that could develop over time, some sports injuries can lead to the deterioration of the knee joint tissues inside the knee.

Symptoms of Osteoarthritis

The most common symptoms of knee osteoarthritis are pain and stiffness. The pain may be mild at first and only occurs when the knee is used for a long time, such as when walking or climbing stairs. As the condition progresses, the pain may become more severe and happen even when you are resting, becoming chronic pain.

This condition can be present in older people and younger patients depending on their medical history. A more comprehensive list of the symptoms of knee arthritis includes:

– Stiffness in the knee, especially in the morning or after sitting for a long period

– Swelling in the knee

– Crunching or grinding sensation when moving the knee

– Weakness or instability in the knee


Injuries Where Knee is Bone on Bone

If you have suffered a knee injury, you may be at risk for knee joint degeneration. The main cause of your knee being bone-on-bone is an injury to the meniscus. The meniscus is a piece of knee cartilage that cushions the knee joint like a shock absorber. A torn meniscus can cause the knee joint to grind against itself, leading to pain and stiffness.

Another knee injury that may lead to bone-on-bone is a fracture. A fracture can damage the cartilage in the knee joint and soft tissue, causing it to degenerate.

Ligament injuries, such as a torn ACL, can also cause knee joint degeneration. A ligament is a type of tissue that connects the bones in the knee joint. When a ligament is injured, it can cause the knee joint to become unstable and acutely tear the meniscus.

How is Osteoarthritis Diagnosed?

Osteoarthritis is the most common type of knee joint degeneration. Osteoarthritis is diagnosed by a combination of symptoms, x-rays, a CT scan, or an MRI.

If you are concerned that you may have knee joint degeneration, it is important to see your doctor. They will be able to diagnose the condition and discuss a treatment plan or various options with you.

Knee Osteoarthritis Progression

The knee is a weight-bearing joint, which means that it supports the weight of your body. When the cartilage in the knee joint breaks down, the bones begin to rub against each other. This can lead to pain and stiffness in the knee. The knee may also swell and feel warm to the touch.

As osteoarthritis progresses, the knee joint may become deformed. The knee may start to bow out or in, and the bones may rub against each other, causing pain.

In some cases, the knee joint may become so damaged that it needs to be replaced.

Treatment Options for Knee Joint Degeneration

If you have been diagnosed with knee joint degeneration, there are several treatment options available to you. Take a look and decide which would be best for you.


Several types of medication can be used to treat knee joint degeneration. Anti-inflammatory medications, such as ibuprofen, can help to reduce the pain and inflammation in the knee joint. Steroid injections can also be used to reduce inflammation.

If these methods do not work, your doctor may prescribe a stronger pain reliever or recommend surgery.

A couple of examples of stronger medications are opioids and tramadol. It is safe to note these stronger medications come with side effects and possible addiction.

Surgical Options

If knee joint degeneration is severe, you may require surgery. One surgical option completed by an orthopedic surgeon, in this case, is knee replacement surgery. In this procedure, the damaged knee joint is replaced with an artificial one. This can provide pain relief and improve knee function. This is a major surgery that requires a long recovery time.

Another surgical option is knee arthroscopy. This is a minimally invasive procedure where the damaged cartilage in the knee joint is removed. It can provide relief from pain and stiffness.

The last common surgical option is an osteotomy. In this procedure, the bones in the knee joint are cut and realigned. This can help to reduce knee pain and improve knee function.



My preferred treatment option for knee joint degeneration is rehabilitation through targeted joint exercises. This is a conservative treatment option that can help to improve knee joint function and reduce pain.

Generally, while physical therapy and physical therapists are quite helpful, they may not be enough to provide the type of exercises necessary for natural rehabilitation from a condition like this.

Rehabilitation Exercises

If you are dealing with knee joint degeneration, rehabilitation through targeted joint exercises is an effective treatment option. Several exercises can help to improve knee joint function and reduce pain. Here are a few such exercises:

One knee rehabilitation exercise is the step up. This exercise helps to strengthen the muscles around the knee joint and improve knee joint function. The main muscle this exercise works is the VMO or the vastus medialis oblique. This is the muscle that stabilizes the knee joint.

Another exercise that has been proven to be beneficial to knee joint health is pulling a sled. This exercise helps to strengthen the muscles around the knee joint, as well as improve knee joint function. The main muscle this exercise works is the quadriceps while strengthening the joint through its functional range of motion.

Strengthening the knee joint alone sometimes calls for strengthening the muscles around the knee as well. The tib raise strengthens the tibialis anterior which is a muscle on the front of the shin bone that helps you lift your foot when you walk and is the first line of defense of a healthy knee. This muscle is used frequently in everyday activities for walking, running, etc.

To exercise this muscle simply stand with your back on the wall and keep your knees straight. To initiate the exercise lift your toes toward the ceiling, hold at the top, and slowly lower back down. As a beginner, you will become quite sore, because this muscle is not generally exercised by athletes or those who work out frequently.

The last rehabilitation knee exercise is a full-range split squat. This exercise allows patients to regain previously lost or avoided ranges that help promote overall knee health. This exercise works the VMO, quadriceps, and hamstrings all while going through a full range of motion.

This variation of the split squat also aims to create equal strength from one leg to the other, which is a common struggle among those who have joint injuries.

Knee Braces

Along with rehabilitation, it is also common for individuals with knee joint degeneration to use knee braces. Knee braces help to stabilize the knee joint and can provide pain relief. Many different types of knee braces are available on the market. Some common types of knee braces include:

– hinged knee brace

– patellar stabilizing knee brace

– unloader knee brace

– knee immobilizer

Each of these knee braces has a different purpose and can be used to treat different symptoms. It is important to consult with a doctor or knee specialist to determine which type of knee brace is right for you.

Weight Loss

While muscle strength and bracing may assist with degenerative joint disease, there are additional ways to get the best results. If you are overweight or obese, knee joint degeneration can be exacerbated.

Losing weight can help to reduce the amount of stress on the knee joint and improve knee joint function.

Not only will losing weight help your joints overall, but it has a plethora of other health benefits. These include reducing your risk of heart disease, stroke, and high blood pressure all while raising your quality of life.

There are several ways to achieve a healthy weight. The best way is to eat a healthy diet and exercise regularly. This will help to boost your metabolism and burn more calories, allowing you to lose weight safely and effectively.

Nutrition that is based on natural foods, including fruits, vegetables, whole grains, and lean protein can help you lose weight safely. Avoiding processed foods, sugary drinks, and excessive amounts of fat is also important.

Including physical activity in your daily routine is essential for weight loss. You do not have to go to the gym to exercise. Many daily activities can help you lose weight, such as walking, jogging, swimming, and biking.


If you are dealing with knee joint degeneration, there are several treatment options available. Surgery is an option for some, but rehabilitation and weight loss are also effective methods. These less invasive options can help to improve knee joint function and reduce pain.

In conclusion, knee joint degeneration is a common problem. There are several treatment options available, depending on the severity of the condition. Less invasive options, such as rehabilitation, medication, and weight loss, are often effective in improving knee joint function and reducing pain.

Surgery is an option for some people, but it is not always necessary. Speak with your doctor about which treatment option is right for you.

About the Author

Hi there! I’m Dr. Keagen Hadley, OTD, OTR/L. Straight out of the University of Mary, I’m all about blending my know-how in knee health, well-being, and medical technology. As a licensed occupational therapy doc, I’m here to translate complex concepts into clear, actionable insights – whether it’s knee care or groundbreaking healthcare tech.

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