Avoiding A Knee Replacement: Conservative Treatment Options

Knee Replacement Procedures are usually the last resort for knee pain and arthritis. There are lifestyle changes you can try to help avoid the surgery. Orthopedic Doctors also have conservative treatment options available that can help people who are trying to delay or avoid knee replacement surgery.

Ways To Avoid a Knee Replacement

There are 2 things you can do on your own to try to avoid a knee replacement if you have knee pain or severe knee arthritis. 

1. Lose Weight 

Excessive body weight place extra force on the knees. If there is arthritis in the knees, the extra weight can increase pain and cause more wear and tear. Click to learn Tips to Lose Weight.

2. Exercise

Most of the time, knee replacements are needed when there is severe arthritis in the knee. Exercises can help to stabilize the joint and improve mobility. This can help with pain and function with an arthritic knee. Low impact exercises such as riding a stationary bike are typically recommended with knee arthritis.

senior citizen couple riding stationary recumbent bikes to avoid a knee replacementRiding Recumbent Bike

8 Conservative Treatment Options For Knee Pain and Arthritis

There are non-surgical treatments that can help with knee pain and arthritis. They include:

  • Physical Therapy
  • Supplements
  • Steroid Injections
  • Hyaluronic Acid Injections
  • Platelet Rich Plasma Injections
  • Stem Cell Therapy
  • Knee Braces
  • Acupuncture

Physical Therapy for Knee Pain and Arthritis

Physical therapy is the first line of defense with knee pain and arthritis. Studies show that strengthening the specific muscles around the knees and hips can help with pain and function.

Strength training improves the stability and function of joints. When there is pain and inflammation in the knee, the brain tends to shut down the normal control and sequencing of muscle contractions around the joint. This is a protective response but the problem is that the muscle control does not always return on its own.  

A physical therapist can help to re-educate the muscles around the knee and hip to allow optimal knee function. 

Physical therapy can also help to manage pain and improve the range of motion in the knee. 

Most Insurance plans include physical therapy benefits.

Male physical therapist working with a male patient to improve the function of the left kneePhysical Therapy for Knee Pain

Supplements like Glucosamine and Chondroitin Sulfate are substances found in joint surface cartilage. Some doctors recommend taking supplements of Glucosamine and Chondroitin Sulfate to help with articular cartilage health. 

There are conflicting studies on whether taking Glucosamine and Chondroitin Sulfate help with joint pain from arthritis.

Pain Medications

Medication for pain and inflammation can be helpful to manage knee pain. But, they should be used with care. There are risks associated with most anti-inflammatory meds. Some pain medications can have addictive qualities.  

Prescription pain and anti-inflammatory medications should only be used under the direction of a physician.

Steroid Injections

Steroid injection are helpful with decreasing the inflammation in an arthritic knee. Decreasing the inflammation can help to lower the pain level and allow the knee to move better and tolerate activity better.

Image of a doctor drawing steroid injection into a syringe to inject in a kneeSteroid InjectionsInjected steroids allow the physician to place the steroid inside the joint capsule to focus on the local area. Oral steroids can also be helpful but injected steroids are more focused at the location of the joint pain. 

Steroid injections have some risks and there are limitations on how many can be used. But, they can help some patients to return to daily activity and regain strength and motion. 

Hyaluronic Acid Injections

Hyalurone is a natural material in the synovial fluid or lubricant of your joints. When the joint begins to wear out with arthritis, the lubricant breaks down too.  

Injecting synthetic Hyaluronic Acid into an arthritic knee can help decrease pain in patient with arthritic knee pain.

There are several brands of Hyaluronic Acid. The brand chosen may be dependent upon insurance authorization. 

Platelet Rich Plasma Injections (PRP)

Platelet Rich Plasma Injections are an option for some patients with knee pain. 

When the body is injured, proteins in the blood are carried to the area to manage the healing process. Platelets are blood cells that help with clotting after an injury, but they also release these proteins in the injured area. 

With PRP Injections, the patient's own blood is drawn and placed in a centrifuge. The blood is spun to separate out platelet cells and plasma. The high concentration of plasma with platelet cells is then injected into the injured or painful area.  

image of a clinician's hand holding a test tube with platelets and red blood cells separated with a centrifuge. Centrifuge is open and finishedCentrifuge with platelets separated in test tube
The high concentration of platelets can help to stimulate a repair process and speed up healing of the tissue. 

Insurance coverage for PRP injections varies. 

Stem Cell Therapy

Stem Cell therapy is great option for some patients with knee pain and arthritis. It has a low risk of complications.

Stem cell that has been harvested from the patient's pelvis or ilium to place in the knee for knee pain and arthritis.Stem Cells
Stem Cell therapy is a safe and ethical treatment option. Stem cell therapy in orthopedics uses adult autologous stem cells (not from an embryo). Adult mesenchymal stem cells are primitive cells that self-replicate and differentiate into many types of cells. This is beneficial for many parts of the body. In orthopedics, adult stem cells are used to help regenerate:

  • Bone
  • Cartilage
  • Connective tissue
  • Adipose (fat)

The Orthopedic Surgeon aspirates bone marrow from the patient's own pelvis. The stem cells are separated with a centrifuge and injected into the damaged area.  

Insurance coverage for Stem Cell Therapy varies.

Knee Braces

Severe knee pain and arthritis may improve with a knee brace. There are several types of knee braces that can help with knee arthritis.

1. Unloader Knee Brace

An Unloader knee brace helps to change the direction of force on the knee. This is beneficial when one side of the knee is more worn out than the other. The unloader brace applies pressure the the knee to decrease the load on the compartment of the knee that is the most painful.  

Image of a Medial compartment unloader brace on the right knee to unload the medial knee compartment and limit knee hyperextension. Labels to shoe direction of forceMedial Unloader Knee Brace

Unloader knee braces can help to slow the progression of knee arthritis in one compartment of the knee. This can improve function and walking/daily activity tolerance. 

2. Double Upright Knee Brace

The Double Upright knee brace is a neoprene material with metal supports and hinges on each side. It is used to provide support and limit excessive movement or hyperextension of the knee.

Image of a DONJOY double upright knee brace on a right kneeDouble Upright Hinged Brace
The Double Upright Knee Brace is used more commonly with earlier stages of arthritis in the knee. 

Most Insurance plans include durable medical equipment or bracing benefits.

Dry Needling 

Dry Needling is an alternative treatment option for knee pain and arthritis.   Specially trained clinicians in Physical Therapy use needles for a modern treatment environment. 

Acupuncture needles in a left knee to help with knee pain and knee arthritisDry Needling
Dry Needling is used to manage pain and to improve function. This helps patients manage pain and total body health.

Dry Needling  is offered mostly as a Self-Pay Treatment but is typically an affordable option provided by JOI Rehab. 

What If Conservative Knee Treatment Does Not Help?

Even with conservative treatment options, sometimes people still need knee replacement surgery. The good news is that knee replacement procedures have advanced over the past 20 years. Whether you need a total knee replacement or a partial knee replacement, the procedures and care management have never been better. 

Many knee replacement procedures are performed with Mako Robotic-Arm Assisted Surgery. Robotic assistance helps to improve surgical precision and allows the surgeon to pre-plan the procedure based on the specific anatomy of the patient's knee. 

Hospital stays are shorter than they used to be with Knee Replacements. In some cases, a 23 Hour Joint Replacement is used so patients can go home quickly. With some younger knee replacement candidates, Same-day surgery is now an option. 

Click to learn what to expect after having a total knee replacement and Best Exercises after a Knee Replacement.

Conservative Knee Treatment in Jacksonville FL

All of these treatments can be helpful when a Knee Replacement is not an option for you for whatever reason. These conservative treatment options are all offered at the Jacksonville Orthopaedic Institute. 

Please watch this video on How To Put On a Medial Unloader Brace.

To schedule an appointment with a JOI Knee Orthopaedic Surgeon, call (904)JOI-2000, schedule online, or click the link below. To schedule a Physical Therapy appointment at 1 of our 12 JOI Rehab offices, call (904)858-7045.

See a Knee Specialist

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Image of Ehren Allen, DPT, COMT and title Medical Content Writer

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