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Non-Surgical Knee Surgery Alternatives

Before deciding on knee surgery, your physician may try several knee surgery alternatives to relieve the pain and inflammation in your knee.

Knee Surgery Alternatives: Lifestyle Modification

The first alternative to knee surgery most physicians try is lifestyle modification. This may include weight loss, avoiding activities such as running and twisting which can aggravate the knee injury, modifying exercise to no- and low-impact, and other changes in your daily routine to reduce stress on your knee.

Knee Surgery Alternatives: Exercise and Physical Therapy

Exercise and physical therapy may be prescribed to improve strength and flexibility. Exercises may include strengthening exercises such as riding a stationary bike, and stretching exercises such as flexing the ankle up and down, tightening and holding thigh muscles, sliding the heel forward on the floor, leg lifts, and knee extensions.

Exercise can strengthen your leg muscles and reduce your pain. If you really need knee surgery, this may not help, but many forms of knee pain can be mitigated by exercise.

Knee Surgery Alternatives: Anti-inflammatory Medications

Arthritis pain can be caused by inflammation in the knee and by the bones rubbing against each other due to eroded cartilage. Reducing the inflammation of the tissue in the knee can provide temporary relief from pain and delay knee surgery.

Anti-inflammatory medications may be prescribed to decrease swelling in the joint. They also may provide some analgesia or pain relief even if no swelling is present in the knee. Newer medications called Cox-2 inhibitors may also be used to reduce inflammation, reducing pain temporarily. These medications are safer for patients with a history of ulcers, gastritis or reflux. A corticosteroid injection may also be used to reduce pain; in this procedure a powerful anti-inflammatory agent is injected directly into the joint.

Knee Surgery Alternatives: Glucosamine/Chondroitin

A dietary supplement called glucosamine/chondroitin may improve the joint's mobility and decrease pain from arthritis of the knee. Glucosamine and chondroitin sulfate can slow the deterioration of cartilage in the joint, reducing the pain of bone on bone. Both are naturally occurring molecules in the body. Glucosamine is thought to promote the growth of new cartilage and repair of damaged cartilage, while chondroitin is believed to promote water retention, improving the elasticity of cartilage, and also to inhibit cartilage-destroying enzymes.

Knee Surgery Alternatives: Joint Fluid Therapy

While medications and supplements can be helpful in reducing inflammation and pain and help you delay or avoid knee surgery, there are trade-offs. Drug therapies may have side effects, and there is a limit to how much pain reduction can occur. The effectiveness of medications also diminishes over time for most patients.

In a procedure called joint fluid therapy, a series of injections is made directly into the knee joints. This therapy is designed to reduce pain by improving lubrication in the knee, replacing the synovial fluid that lubricates the knee. Joint fluid in an arthritic knee loses viscosity and becomes more watery and less able to lubricate the joint. The body's own hyaluronan acts like a lubricant and shock absorber in synovial fluid of a healthy joint. Osteoarthritis reduces your synovial fluids ability to protect and lubricate your joint. Hyaluronate is used to replace some of the lost viscous joint fluid in the treatment of osteoarthritis knee pain in patients who have failed to get adequate relief from simple painkillers or from exercise and physical therapy.

There are several brand names for these solutions and each can claim some success in alleviating osteoarthritic knee pain. These include Synvisc, Orthovisc, Euflexxa, Supartz and Hyalgan. The number of recommended injections varies. They are usually done once a week. The decision to offer this treatment option by your physician will be based on their best judgement as to your likely response. The best outcomes are for patients with mild to moderate arthritis with mild deformity and not significantly overweight.

Learn more about knee surgery alternatives and joint fluid therapy from the Smith & Nephew Web site...


A brace may be used to provide external stability to the knee joint. Braces are devices made of plastic, metal, leather and/or foam and are designed to stabilize a joint, reduce pain and inflammation and strengthen the muscles of the knee. By putting pressure on the sides of the joint, the brace causes the joint to realign, which in turn decreases the contact between the two rough bone surfaces and reduces the pain while increasing mobility.

As you can see there are several non-surgical options for treating osteoarthritis. These methods can delay knee surgery by providing short-term relief. However, any drug therapy program is likely to have side effects which should be taken into consideration. Non-surgical procedures may also have limited results compared to the long-term results of knee surgery.

SUPARTZ is a trademark of The Seikagaku Corporation.