If knee pain is making walking, climbing stairs or getting up from a chair increasingly difficult, the most important question is not simply whether an X-ray shows “arthritis.” The key questions are how advanced the osteoarthritis is, what is actually generating the pain, and which treatment makes sense at this stage.

In Dubai, Dr. Mohamed Koura, Specialist in Pain Medicine in Dubai, evaluates knee osteoarthritis using a diagnosis-first approach. Treatment may include rehabilitation and lifestyle measures, a targeted intra-articular option such as HYMOVIS an (intra-articular cross-linked hyaluronic acid) for appropriate patients, or genicular nerve radiofrequency when persistent pain is being driven through selected sensory nerve pathways.

The aim is to match treatment to the stage of osteoarthritis, the pain source and the patient’s function rather than offering the same conservative plan , injection or procedure to everyone. smaller group with very advanced structural disease may need an orthopaedic surgical opinion; this article focuses mainly on non-surgical options.

What Is Knee Osteoarthritis?

Knee osteoarthritis (OA) is a degenerative condition involving progressive changes in the cartilage, bone and other structures of the knee joint.

It is often described as “wear and tear,” but the condition is more complex than cartilage loss alone. Joint inflammation, bone changes, muscle weakness and altered mechanics can all contribute to symptoms.

Importantly, the severity of osteoarthritis on an radicological scans does not always match the severity of pain. Some people have significant radiographic changes with relatively limited symptoms, while others experience major pain and disability with less dramatic imaging findings.

That is why treatment should be based on the  patient’s clinical condition, the radiographic grade of knee osteoarthritis, pain severity, pain tolerance, and clinical examination findings, rather than relying on radiological scans findings alone.

What Are the Symptoms of Knee Osteoarthritis?

Common symptoms can include:

• Pain while walking or standing for longer periods.
• Pain when climbing or descending stairs.
• Stiffness after sitting or on first getting up.
• Difficulty fully bending or straightening the knee.
• Grinding, creaking or clicking sensations during movement.
• Recurrent swelling in some patients.
• Reduced walking distance and confidence.
• Pain that begins to affect sleep or daily activity in more advanced cases.

However, not every knee pain is caused by knee osteoarthritis, so confirming the pain source matters before treatment begins.

Is Every Knee Pain Caused by Osteoarthritis?

No.

Knee pain can also result from meniscal injury, tendon problems, ligament injury, inflammatory disease or other joint conditions.

Pain can also be referred from the hip or spine. In some patients, lumbar spinal stenosis or nerve-related problems may produce pain, heaviness or weakness around the leg and knee that can be mistaken for primary knee disease.

For that reason, simply treating an X-ray finding without checking whether it matches the symptoms may lead to the wrong treatment target.

How Is Knee Osteoarthritis Assessed in Dubai?

Assessment begins with the pattern of pain, the activities that trigger it and how much it limits function. The knee is then examined for movement, stability, tenderness, swelling and mechanical symptoms.

Depending on the clinical picture, evaluation may include:

• Weight-bearing or other appropriate knee X-rays.
• MRI when another problem such as meniscal or ligament pathology is suspected or symptoms do not match the plain X-ray.
• Review of previous injuries or knee surgery.
• Review of medications, physiotherapy and previous injections.
• Assessment for hip, spine or neurological causes when the symptoms suggest a different pain source.

The goal is not only to grade the arthritis. It is to understand what is driving the pain and which treatment is most likely to fit the patient's current stage and functional goals.

Can Knee Osteoarthritis Be Treated Without Surgery?

Mainly yes, particularly when there is no clear indication for joint replacement.

A non-surgical plan may include:

• Staying active while modifying activities that repeatedly aggravate the joint.
• A structured physiotherapy or exercise programme to strengthen the muscles around the knee.
• Weight reduction when appropriate to reduce load on the joint.
• Suitable pain medication or anti-inflammatory treatment when medically appropriate.
• Walking aids or supports when needed.
   

If pain persists despite appropriate conservative treatment, further interventions may be considered based on the patient's clinical condition. Dr. Mohamed Koura offers HYMOVIS injections as one of the treatment options for well-medically selected  patients with knee osteoarthritis. Genicular nerve radiofrequency ablation may also be considered when clinically indicated. The choice of treatment by dr.koura depends on the severity of symptoms, degree of joint degeneration, clinical examination findings, and response to previous therapies.

Clinical Evidence on HYMOVIS: Research Findings, Efficacy, and Patient Outcomes

HYMOVIS has been evaluated in several important clinical studies over the whole world investigating its effectiveness in patients with symptomatic knee osteoarthritis. In a 2016 multicentre, open-label Phase III study published in the European Review for Medical and Pharmacological Sciences, Benazzo et al. followed 50 patients for 52 weeks and reported improvements in pain, stiffness, physical function, and overall WOMAC scores. In a 2017 retrospective observational study involving 937 patients, researchers reported a 56.3% reduction in mean WOMAC scores after six months, alongside improvements in resting and movement-related pain. Another randomized controlled study published in 2016 by Bisicchia, Bernardi, and Tudisco, conducted at the University of Rome Tor Vergata in Rome, Italy, compared HYMOVIS with intra-articular methylprednisolone acetate in 150 patients. The HYMOVIS group demonstrated significantly better total WOMAC scores at 6, 12, and 26 weeks, although this difference was not maintained at one year. More recently, a randomized, double-blind, multicentre study published in Osteoarthritis and Cartilage Open in 2026 compared a single HYMOVIS injection with MONOVISC in 347 patients. Walking-related pain scores improved by 65% at 12 weeks and 73% at 26 weeks in the HYMOVIS ONE group, and the treatment demonstrated non-inferiority to MONOVISC. Overall, these findings suggest that HYMOVIS provide meaningful improvements in pain and physical function in well medically selected patients with knee osteoarthritis

HYMOVIS Knee Injections in Dubai by Dr. Mohamed Koura

HYMOVIS is an FDA-approved intra-articular hyaluronic acid treatment designed to relieve pain associated with knee osteoarthritis in patients who have not responded adequately to conservative treatments. Dr. Mohamed Koura offers HYMOVIS injections as one of the treatment options for selected patients with knee osteoarthritis in Dubai. Its modified hyaluronic acid formulation is designed to enhance the viscoelastic properties of synovial fluid, supporting joint lubrication and shock absorption while potentially improving pain and functional mobility. By improving the intra-articular environment, HYMOVIS may help support joint function, intra and extra-articular structures like knee cartilage and facilitate daily activities. However, although it may contribute to symptom management.

Genicular Nerve Radiofrequency for Knee Osteoarthritis Pain in Dubai

For selected patients with chronic knee osteoarthritis pain that remains limiting despite appropriate conservative treatment, genicular nerve radiofrequency treatment may be considered.

the procedure targets selected sensory nerve branches around the knee that carry part of the pain signal from the joint. A needle is guided precisely to the intended nerve targets and radiofrequency energy is used to modify pain transmission.

The goal is pain reduction and improved function in an appropriately selected patient, not a change in the X-ray appearance of the joint.

When May Knee Radiofrequency Be Considered?

It may be evaluated when:

• Knee pain is chronic and significantly limits walking or daily activity.
• Conservative treatment has not provided adequate relief.
• Osteoarthritis is believed to be the main source of the pain.
• Better pain control may help the patient move, exercise or participate in rehabilitation.

In some cases, a genicular nerve block may be used as a diagnostic or prognostic step to help determine whether targeting these sensory nerves is reasonable before radiofrequency treatment.

When Is an Orthopaedic Surgical Opinion Still Important?

In very advanced cases where it is clinically indicated, the patient may be referred for an orthopaedic surgical assessment.

Why Does Technical Experience Matter in Genicular Nerve Procedures?

Knee radiofrequency is not simply “an injection around the knee.”

It requires:

• Detailed understanding of the sensory nerve anatomy around the joint.
• Appropriate selection of nerve targets according to the patient's pain pattern and clinical findings.
• Accurate image-guided needle placement.
• Recognition of pain that is coming from the knee versus the hip, spine or another structure.
• Knowing when a pain procedure is not appropriate and another treatment pathway is needed.

Patient selection is part of the technical expertise, particularly because the anatomy, pain distribution and severity of osteoarthritis vary from one patient to another.

When Should Knee Pain Be Assessed Urgently?

Seek prompt medical assessment if knee pain is associated with:

• Sudden marked swelling.
• Significant redness and warmth with fever or systemic illness.
• Inability to bear weight after an injury.
• A locked knee or sudden inability to move it normally.
• New weakness or neurological symptoms in the leg.

These features should not simply be assumed to represent osteoarthritis.

Why Consider an Assessment with Dr. Mohamed Koura in Dubai?

Dr. Mohamed Koura practices interventional pain medicine in Dubai, treating spine and joint pain with diagnosis-led, image-guided procedures when they are appropriate.

His international professional qualifications listed on drkoura.com include:

Fellowship in Interventional Pain Practice (FIPP)

World Institute of Pain

European Diploma in Pain Medicine (EDPM)

European Pain Federation – EFIC

Dr. Koura's website documents his work in knee osteoarthritis and therapeutic knee injections, alongside radiofrequency and other interventional pain procedures for selected patients.

The advantage of having several treatment options is the ability to distinguish the patient who needs rehabilitation, the patient who may benefit from an intra-articular injection, and the patient whose pain pattern is more appropriate for a sensory-nerve procedure such as radiofrequency.

Knee Osteoarthritis Treatment in Dubai

If you live in Dubai or elsewhere in the UAE and have persistent knee pain, difficulty walking or climbing stairs, stiffness or a previous diagnosis of knee osteoarthritis that has not improved as expected, you can arrange an assessment with Dr. Mohamed Koura in Dubai.

Your symptoms, function, imaging and previous treatment can be reviewed to determine whether the next step should be:

• Conservative management and rehabilitation.
• An intra-articular therapeutic injection when appropriate for the diagnosis.
• A genicular nerve block when appropriate.
• Genicular nerve radiofrequency for selected patients.
• An orthopaedic opinion only when the joint is too advanced for continued non-surgical management.

The objective is not to choose the most advanced procedure. It is to choose the treatment that best fits the current stage of the knee problem.

International Patients Travelling to Dubai for Knee Treatment

Dr. Koura also sees international patients who travel to Dubai for specialist assessment of knee pain and interventional treatment when appropriate.

Patients from nearby countries including Saudi Arabia, Kuwait, Qatar, Bahrain, Libya and Iran can contact the clinic before travelling to ask which reports and imaging should be available.

An Online Consultation can also be arranged for patients outside Dubai to review the condition, available reports and next steps before travel when needed.

Contacting the clinic or having an online assessment does not mean that an injection or radiofrequency procedure will automatically be recommended. Treatment is based on the full clinical assessment.

Knee Pain Limiting Your Movement? Start by Identifying the Stage and Source of Pain

If knee pain is limiting walking, stairs, exercise or normal daily activity, do not start by choosing an injection or procedure yourself.

Start with an assessment that determines whether the pain is truly coming from knee osteoarthritis, how advanced the joint changes are, and whether the next step should be rehabilitation, an intra-articular injection, genicular nerve radiofrequency, or a different pathway.

Book Your Assessment with Dr. Mohamed Koura

You can visit Dr. Mohamed Koura for a specialist assessment and to discuss the treatment options most appropriate for your condition at our clinics in Egypt or Dubai.

If you live outside Egypt or Dubai, an Online Consultation is also available to review your condition, medical reports and available imaging, and to discuss the next steps before arranging travel when needed.

Egypt | Dubai | Online Consultation

Book your appointment or contact our clinic team to find the most suitable consultation option for you.