Abstract
Osteoarthritis (OA) is a common joint disorder in the elderly and Knee osteoarthritis contributes to 80% of OA burden. Grade 4 osteo arthritis defined using the Kellgren-Lawrence system is the advanced stage of Knee OA. Total knee replacement (TKR) is largely advised for grade 4 Knee OA where conservative treatments do not yield results. In Ayurveda, grade 4 Knee OA is diagnosed and treated based on the principles of the Vata vyadhi (diseases due to Vata) spectrum of diseases.
A 68-year-old female patient was diagnosed with Grade 4 osteoarthritis following a Knee X-ray and was presented with an 18-year-old history. The patient had previously consulted different medical systems like conventional medicine, Ayurveda, and Homeopathy, but there was no significant improvement. The symptoms of the patient were analyzed stage-wise and were treated only with internal Ayurveda medicines for two months. The report demonstrates the application of treatment principles advocated in classical texts employed along with appropriate rehab measures following the stage-wise evaluation of the pathology. The WOMAC scores and TUG test scores have shown considerable improvement following the Ayurveda management. The treatment improved the quality of life of the patient, as evidenced by the improvement in the WOMAC score and the patient's perspective.
The case demonstrates the potential of Ayurveda to offer a cost-effective alternative to complex and expensive therapies like TKR in osteo arthritis

Key words: Grade 4 Osteoarthritis, Ayurveda, Knee OA, Rehabilitation, Alternative to TKR