14 Alternatives to Knee Replacement Surgery in 2023

Platelets are rich in growth factors, hence help to treat the knee.

Research indicates PRP is effective for mild to moderate knee osteoarthritis.^[9]

It offers pain relief and improved activity levels for a year after one injection.^[10]

However, the evidence of its efficacy is insufficient & requires more research.

Ultrasound-guided PRP

In prolotherapy, the physician injects dextrose solution into the affected area.

This solution stimulates the healing by increasing the blood flow to that area.

It's often called "regenerative injection" or "proliferation therapy."

Research shows that prolotherapy reduces pain and stiffness.^[11]

Moreover, you may see a constant and significant improvement in joint function.

While this procedure is safe, it requires more research.

Prolotherapy

Hyaluronic acid is similar to a substance that is produced endogenously by special cells in joints called type B synovial cells.

It acts as a lubricant and shock absorber for the joints, ensuring their proper function.^[13]

It's injected directly into the knee joint, typically around 2 ml.^[14]

Despite being the most researched joint injection, rigorous studies have yet to demonstrate significant patient benefits.^[15]

Thus, the Arthritis Foundation guidelines do not currently recommend their use.^[16]

HLA Injection

This minimally invasive procedure is performed by an Interventional Radiologist (IR).

GAE restricts blood flow to inflamed knee linings.^[14]

This reduces inflammation and may alleviate or eliminate knee pain in osteoarthritis.

In 2020, a study found it effectively reduced knee pain, especially in those with moderate to severe knee pain.^[15]

However, there's limited evidence on the safety and effectiveness of GAE for knee osteoarthritis. Only three systematic reviews have been published on this topic so far.^[16]

Genicular Artery Embolization

An Unispacer is a device inserted into the affected knee joint.^[17]

It serves as a spacer to separate worn knee surfaces.

It doesn’t require cutting bone and cementing an implant.^[18]

However, only a few individuals are eligible for this device.^[19]

A recent study revealed a 53% 10-year survival rate for the Unispacer.^[20]

Patients with the implant experienced satisfactory clinical outcomes.

Unispacer

8. Radiofrequency Ablation (RFA) - Minimally Invasive

RFA controls knee pain by destroying the sensory nerves that transmit pain signals from the knee to the brain.

Its non-invasive nature and low complication rate make it an excellent alternative to knee replacement surgery.

Research indicates RFA is safe and effective for osteoarthritis pain and knee function.

The procedure is approved by the FDA.

RFA

NSAIDs may reduce pain, inflammation, and swelling.

However, its prolonged consumption may cause stomach ulcers, kidney damage, and gastrointestinal bleeding.

OTC drugs may also help manage pain.

Another option is Corticosteroid injections. This can reduce knee pain and inflammation.

Pain relief works for 1 to 6 weeks, but no evidence of lasting relief.

Medication and Steroid Shots

Acupuncture uses thin, sharp needles to alter the energy flow within the body.

It brings relief from joint pain and has a low risk.

Research suggests it can provide short-term relief (up to 13 weeks) for severe osteoarthritis.^[27]

The Arthritis Foundation guidelines support its use.^[28]

Acupuncture

Physical therapy aims to reduce pain and strengthen knee muscles.^[29]

A physical therapist will guide you to ensure you do the exercises correctly.

The therapy approach may include

• Ice and heat application
• Neuromuscular training
• Strengthening exercises
• Stretching exercises

Yoga

Assisting aids include walking canes and braces.

These devices perform the following functions:

• Improve mobility
• Better stability and support
• Help prevent knee pain and inflammation from getting worse.

Knee Brace

Ayurveda treatment involves a combination of massage, meditation, exercise, and a nutritional diet.

However, it is an individualized treatment according to the patient’s condition.

Ayurveda naturally revives damaged cartilage and prevents further deterioration in the knee joint.^[30]

Recent research found that Ayurveda notably improved knee pain and function in severe osteoarthritis (Grade IV).^[31]

Leg Massage - Ayurveda

Obesity can put excess stress on the knee joint.

When walking on level ground, your knees endure 1.5 times the force that they endure from your body weight when you stand still.

So, with each step, a 200-pound person exerts a combined force of 300 pounds distributed over the two knee joints or 150 pounds of force per knee joint.

Research shows that a 10- to 15-pound weight loss in obese young individuals significantly reduces their future risk of osteoarthritis.

Bariatric surgery can also reduce excessive load on weight-bearing joints.

This can help reduce osteoarthritic symptoms such as difficulty walking and joint pain.

Diet Plan for Weight Loss

Osteotomy involves removing weight from the affected part of the knee.

Hence, this weight shift helps in relieving symptoms.

This procedure helps if there is less damage on only one side of the knee.

However, it works better on younger people.^[33]

Knee Osteotomy

Arthroscopy can repair a meniscus tear, ligament, bone, or cartilage inside the knee.

It involves the use of a camera inserted through small incisions.

Still, this technique may only help for some types of knee problems.

It’s possible to go home a few hours after the procedure.

Knee Arthroscopy