 Hi I am Dr. Srinu Kumar Bhaskaran and I am a knee replacement specialist with Manipal group of hospital based out of Karate. So today I will be talking about knee osteoarthritis. So before we go into the details of the diagnosis and management I would just like to mention exactly what happens in osteoarthritis. So osteoarthritis is when the cartilage that is the cushioning material as we can see in this model here the bluish color structure so that wears out over a period of time and the bones start rubbing on each other there is a friction that happens in between the bones and that is what leads to the pain and deformity in osteoarthritis. So does all patients of osteoarthritis need surgical treatment absolutely not. So the patients who are identified or diagnosed early we can treat them with modalities like medications, give them physiotherapy, braces and in situations where there is significant sort of pain but not complete damage we can also consider modalities like injections what we call as visco supplement injections or PRP injections which has shown to have you know quite a long term kind of benefit for these patients. Of course when all these treatment options fail and the patient is still in pain that is when we offer patients you know surgical treatments. So surgical treatments would involve you know kind of arthroscopy surgeries, partial knee replacements, total knee replacements now that is a call that we take once we see a patient you know both clinically as well as radiologically.