Conservative knee osteoarthritis care: the K-L grade, each step tried and how it worked, and outcome scores over time.
The non-surgical pathway for knee osteoarthritis, tracked step by step so a patient is not sent for a joint replacement until the conservative options have actually been tried and their response recorded. The doctor opens a case for one knee or both with the Kellgren–Lawrence grade, 0 to 4, read from the X-ray (Kellgren and Lawrence, 1957, cited). Each step tried — education, weight management, exercise and physiotherapy, a brace or walking aid, pain relief, topical treatment, an injection with the knee and what was injected as the clinician records it — is kept with the response seen later: better, no change, worse, not tolerated or not done. Outcome scores are recorded under the tool your clinic uses (KOOS, the Oxford Knee Score or another it names), with pain on the 0–10 scale, and trended first to last; PhysioFlow sessions since the case opened are counted, not copied. A case closes as referred for surgery only once something was tried and every step has its response.
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