The 2019 Arthroscopy Association of Canada (AAC) guidelines provide suggestions for patients with knee OA, including the role of joint injections in improving pain, function, and stiffness in patients with mild to moderate knee OA.
These guidelines discuss the utility and cost-effectiveness of arthroscopic surgery as a treatment for OA of the knee. In these guidelines, they recommend an initial 6-9-month trial of appropriate and comprehensive conservative treatment for all patients before considering operative treatments.
Specifically, the guidelines for treatment of knee OA advise:
Osteoarthritis is the most common form of arthritis and it’s affecting more and more Canadians every year. It’s estimated that by 2035, one in four Canadians with be diagnosed with OA – a disease of the whole joint that leads to the breakdown of joint cartilage and the underlying bone.
OA is sometimes described as degenerative or “wear-and-tear” arthritis. Recent studies suggest there may be an inflammatory component to OA, so it may not just be age-related or caused by overuse. In normal joints, cartilage – the tough elastic material that covers and protects the ends of bones – acts as a cushion and provides a smooth, gliding surface for joint motion. OA causes the cartilage to break down, leading to pain, swelling, and problems moving the joint. As it worsens over time, the cartilage wears away and bone rubs against bone, causing joint damage and increased pain.
OA usually progresses slowly over months or years and early symptoms tend to come and go. It commonly affects the knees, hips, first toes, wrists, thumbs, fingers, and spine. As damage progresses, symptoms can become more constant, occurring at rest and disturbing sleep.
There are a number of methods for classifying the clinical severity of OA, which is important in directing appropriate treatment. The most commonly used is Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) that assesses OA based on pain, stiffness, and physical function.
There are also different methods for determining the severity of OA through imaging.
As X-ray is readily available, the Kellgren-Lawrence grading scale is routinely used to gauge OA disease severity. It is determined by assessing joint space narrowing and bony growths, and is divided into five stages – graded from 0 to 4. The Whole-Organ Magnetic Resonance Imaging Score (WORMS) method grades OA on MRI including articular cartilage, bone marrow alterations, and soft tissue changes around the joint.
STAGE 0 – Joint is healthy and there are no signs of OA.
STAGE 1 – There may be tiny, early changes of the cartilage in the joint, but no appreciable joint narrowing or spurring. At this stage, there is only minor wear on joint components and you rarely experience pain or discomfort.
STAGE 2 – This is considered mild OA. X-rays may show bone spurs, but cartilage is still thick enough to prevent joint space narrowing. Cartilage may be frayed and there may be mild bone marrow alterations. Synovial fluid, which helps lubricate and cushion joints, is typically still present at sufficient levels for normal joint motion. It’s often at this stage where you may first begin experiencing symptoms. They could include pain after a long day of walking or running, greater stiffness in the joint when it’s not used for several hours, or tenderness when kneeling or bending.
STAGE 3 – Classified as moderate OA, cartilage between bones begins to thin, so the space between the bones begins to narrow. This may be associated with larger bone spurs, more bone marrow swelling or cyst formation, and more fluid in the joint. You may experience frequent pain when using the joint, or stiffness after long periods of inactivity or when waking up in the morning. Joints may swell after extended periods of motion, as well.
STAGE 4 – At this stage, OA is considered severe and you may experience great pain and discomfort when using the affected joint, or during rest. The joint space between bones is dramatically reduced, there are bulky bone spurs and the cartilage is often completely gone, leaving the joint stiff and possibly immobile. Synovial fluid can be decreased dramatically, no longer reducing the friction between the bones; or can be increased causing swelling and limiting range of motion of the joint.
Osteoarthritis is a chronic (long-term) disease and, although there is no cure, these newer guidelines suggest earlier treatment and management may slow the disease. Earlier treatment will reduce your symptoms and make it possible for you to lead a full and active life. It’s important to thoroughly discuss all your options with your health care practitioner.
For more information on pain management procedures, please speak to your health care practitioner.
Arthritis Foundation (2021) “Osteoarthritis Symptoms and Diagnosis.” www.arthritis.org. Accessed October 5, 2022.
Arthritis Society Canada (2022) “Osteoarthritis.” www.arthritis.ca. Accessed October 5, 2022.
Arthroscopy Association of Canada (2019) “Arthroscopy Association of Canada Position Statement on Intra-articular Injections for Knee Osteoarthritis.” Orthopaedic Journal of Sports Medicine. 7 (7). Accessed October 5, 2022.
Holland, Kimberly (2021) “Stages of Osteoarthritis (OA) of the Knee.” www.healthline.com. Accessed October 5, 2022.
Bennington-Castro, J. (2020) “What Is Osteoarthritis? Symptoms, Causes, Diagnosis, Treatment, and Prevention.” www.everydayhealth.com. Accessed October 5, 2022.
Osteoarthritis Research Society International (2019) “OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis.” Osteoarthritis Cartilage. Nov; 27(11):1578-1589. Accessed October 5, 2022.
Radiologists are specialized physicians who interpret diagnostic imaging to diagnose and monitor a wide range of medical conditions. At Mayfair Diagnostics, they review X-ray, ultrasound, CT, and MRI studies, among others, analyzinsg images in detail and providing comprehensive reports and clinical recommendations to referring physicians. They collaborate closely with technologists and clinic teams to guide imaging protocols, ensure quality and radiation safety standards, and may perform image-guided procedures such as biopsies or injections. Through their expertise and teamwork, radiologists play a key role in accurate diagnosis, effective treatment planning, and improved patient outcomes.
Administrative professionals support the organization across human resources, marketing, operations, strategic partnerships, finance, information technology, and infrastructure. From recruiting staff to promoting services and improving workflows, they help ensure smooth operations and positive experiences for employees and patients. Through collaboration with clinical and support teams, they provide essential coordination that enables efficient, high-quality service.
Diagnostic Imaging Assistant (DIA) support clinic operations and help ensure a positive patient experience. They assist staff by greeting and preparing patients, confirming information, coordinating appointments, and guiding patients through their visit. DIAs also maintain exam rooms, manage documentation, and ensure supplies and equipment are ready. Through strong customer service, attention to detail, and teamwork, they help create a safe and organized environment.
Patient Experience Coordinators (PECs) are the first point of contact, scheduling exams and ensuring accurate patient information. They communicate clearly with patients, coordinate with care teams, and support a smooth, confidential, and customer-focused experience.
Nuclear Medical Technologists perform diagnostic nuclear medicine procedures involving sensitive and highly personal patient circumstances. They are responsible for delivering the highest standard of care in a professional, compassionate, and patient-centered manner, in accordance with provincial regulatory requirements, CAMRT standards, and Mayfair policies and guidelines.
Computed Tomography (CT) Technologists operate CT imaging equipment to produce detailed cross-sectional images of the body that assist in diagnosing a wide range of medical conditions. They prepare and position patients for scans, ensure safety protocols are followed, and administer contrast agents when required. CT technologists work closely with radiologists to ensure high-quality diagnostic images are obtained, while providing clear communication and compassionate care to support patient comfort throughout the procedure.
Magnetic Resonance Imaging (MRI) Technologists operates MRI scanners to produce detailed images of internal body structures used to assist in medical diagnosis and treatment planning. They are responsible for preparing and positioning patients, ensuring all safety protocols are strictly followed due to the strong magnetic field, and obtaining high-quality images as directed by radiologists. MRI technologists combine technical expertise with patient care, providing clear communication and support to ensure a safe, comfortable, and efficient imaging experience.
Diagnostic Medical Sonographers perform ultrasound exams to help diagnose and monitor medical conditions. Following Sonography Canada standards and Mayfair Diagnostics protocols, they capture accurate images while ensuring patient safety, comfort, and confidentiality. They work with radiologists and clinical teams to review requisitions, prepare patients, perform scans, and document findings, contributing to accurate diagnoses and a positive patient experience.
Medical Radiation Technologists (MRTs) perform x-ray, mammography, and BMD exams while ensuring patient safety, accuracy, and compassionate care. They also may assist in pain therapy procedures. MRTs verify patient information, explain procedures, position patients, and produce high-quality images. MRTs follow professional standards and protocols, maintaining strict radiation safety, quality assurance, and patient privacy while supporting a positive patient experience.
We foster a supportive and collaborative culture designed to encourage positive patient experiences and build strong working relationships across the organization:
Our core values shape the way we work with patients, partners, and fellow employees. And, more than anything else, they’re what set Mayfair apart. In everything we do, this is what we strive for:
EXCELLENCE
We share a commitment to high quality and excellence in all that we do. This commitment calls on all of us to achieve the very best of our capabilities and exceed our own expectations.
CURIOSITY
We innovate in everything, from services to processes. We believe meaningful change and effective problem solving come only by looking at challenges and opportunities from new angles and by exercising our creativity and curiosity.
PASSION
We show pride, enthusiasm, and dedication in everything that we do. We are committed to producing and delivering high-quality results and services. We are passionate about our industry and about our company, services, partners, and patients.
COLLABORATION
Our team is supportive of each other’s efforts; we are loyal to one another; and we care for one another both personally and professionally. We promote and support a diverse, yet unified, team. We work together to meet our common goals across Mayfair clinics, locations, and geographies. Only through collaboration on ideas, technologies, and talents can we achieve our mission and vision.
SERVICE
We take pride in delivering exceptional service every day. We listen to every request with an open mind, always looking for opportunities to go above and beyond to create memorable, personalized experiences. We take responsibility to answer our referrers’ and patients’ requests and respect their time by always responding with a sense of urgency.
Join Mayfair Diagnostics, recognized as one of Western Canada’s premier medical imaging organizations. With a century-long legacy and headquartered in Calgary, Alberta, Mayfair Diagnostics is dedicated to assisting patients in achieving clarity regarding their health.
Operating clinics in Calgary and surrounding areas, Regina, and Saskatoon, our multidisciplinary team of radiologists, technologists, and support staff collaborate seamlessly to deliver high quality patient care. Working here is more than just a job; it’s a strong step towards your future.
OUR TEAMS
We are a dedicated group of professionals who combine skill with compassion to deliver attentive care to our patients. As a reliable partner in their health care journey, we provide high-quality imaging that assists patients, physicians, and other providers in making informed health decisions. Our work goes beyond imaging; it’s about fostering relationships and positively impacting everyone we serve.
OUR VISION
We envision a world where every person has clarity about their health. We innovate and welcome change, promoting leadership and creativity through safe risk-taking. We share best practices, earn peer recognition for our work, and engage top talent to reach our goals.
We strive to be thought leaders and encourage creativity by providing a safe place for calculated risk taking.
We share best practices across our operations and are recognized by our peers for our work. We engage the best to help propel us forward in achieving our goals.
