“What is the alternative to knee replacement surgery?”

There are many alternatives to knee replacement. Depends upon the severity of the arthritis in the knee. Typically standing x-rays and a good physical exam can yield that answer. Options prior to considering a knee replacement including Cortizone injections, synthetic cartilage lubrication injections and in some settings biologic injections such as platelet rich plasma can be performed as well. Physical Therapy oral and topical anti-inflammatory’s and activity modification can also help possibly along with a off-the-shelf or custom knee brace as well.

Many exist: injections of cortisone, hyaluronic acid, biological treatments such as PRP and fat cells, partial knee replacement, possibly arthroscopic surgery, tibial osteotomy, etc. Please check out BoneSmart.org to connect with other patients.

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I would love to tell you there is a good option. In a 40-year-old male, there is occasional injections of steroid (3-4 per year) or viscoelastic supplementation, and meds. Surgical options include osteotomy, or partial knee replacement or perhaps a knee arthroscopy to "clean out" the knee. These surgeries have varying degrees of success.
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Dr. Bose

Alternatives to knee replacement surgery for symptomatic arthritic knees include physical therapy, oral medications, injectable medications, and alternative types of surgery. Physical therapy and home exercise programs will included low impact strengthening and range of motion exercises and if full motion and strength is achieved, even bone on bone knees can sometimes feel normal. It is important to achieve full hyperextension in order to be able to regain full quadriceps strength. Oral medications that reduce inflammation (if there are no medical contraindications), can help during acute swollen times, as can rest, elevation, gentle compression and ice. Some people do well with over the counter medications including chondroitin sulfate/glucosamine, turmeric, omega-3 and others. Always discuss with your physician before starting any medications. Injectables include corticosteroids (should only be done once or twice as repeated injections can make things worse), hyaluronic acid, PRP and stem-cells (many kinds, not all the same). Alternate surgeries can include arthroscopy for loose bodies, symptomatic meniscus tears and excision of impinging bone spurs, biologic cartilage restoration procedures, tibial and femoral osteotomy realignment procedures, fusions (rare cases), and partial robotic knee replacements. See your orthopedic surgeon to help you determine what are the best options for you now and in the future.

Ron Noy, MD, FAAOS

It depends on the severity of the osteoarthritis. Considering you’re quite young for a knee replacement, an osteotomy or distraction therapy with an external fixation could be other options. I advise you to consult an orthopedic surgeon.