IS KNEE REPLACEMENT THE ONLY OPTION FOR SEVERE ARTHRITIS
When someone is told they have severe knee arthritis, the first thing many doctors mention is knee replacement surgery. For decades, this has been the standard treatment that people think about when their knees are causing them serious pain and limiting their daily activities. However, the reality is much more complex than that. There are actually many different options available today for people dealing with severe knee arthritis, and surgery is not always the only path forward or even the best choice for every patient.
Understanding what severe knee arthritis actually is helps explain why so many treatment options now exist. Severe knee arthritis happens when the protective cartilage in the knee joint wears down significantly, causing bone to rub against bone. This creates pain, swelling, stiffness, and reduced mobility. The condition can develop over many years or can be accelerated by injury, overuse, or certain medical conditions. When arthritis reaches the severe stage, people often struggle with basic activities like walking, climbing stairs, or even standing for long periods.
For many years, the medical community treated severe arthritis with a limited set of options. Doctors would typically suggest pain medications, physical therapy, or cortisone injections to manage symptoms. When these approaches stopped working, knee replacement surgery was presented as the next logical step. However, recent medical advances have expanded the treatment landscape significantly, giving patients more choices than ever before.
REGENERATIVE MEDICINE APPROACHES
One of the most exciting developments in knee arthritis treatment is regenerative medicine. These are procedures that use your body’s own healing cells to repair damaged tissue rather than replacing the joint entirely. Regenerative orthopedic procedures are designed to help reduce knee pain and improve function with precise highly specific image-guided medical procedures [3]. These procedures utilize concentrated repair cells that are obtained from your own bone marrow or blood to promote your body’s own natural ability to heal [3].
The most common regenerative approach uses something called Regenexx injectates. These are non-surgical injection-based procedures for people suffering from knee pain due to common injuries to the knee meniscus, ACL, MCL, and other structures, or who are experiencing degenerative conditions such as osteoarthritis [3]. The procedure works by taking cells from your own body, concentrating them, and then injecting them precisely into the damaged areas of your knee using image guidance.
What makes regenerative medicine particularly appealing is the recovery time. Most patients experience little downtime from their procedure using Regenexx injectates and are encouraged to return to activity as they begin to feel better [3]. This is dramatically different from knee replacement surgery, which typically requires months of painful rehabilitation to regain strength and mobility [5].
Another regenerative approach involves stem cell therapy. Stem cell therapy is ideal for degenerative hip and damaged kneecap-induced pain, for those looking for an effective alternative to knee replacement surgery, or for those with joint ligament, tendon, and bone injuries from playing sports [1]. These procedures use enhanced stem cells and exosome growth factors to promote healing. The unique protocols use proprietary cell growth factors to achieve better results via multiple endogenous UC-MSC+ cell infusions and tissue-specific growth factors [1].
Stem cell therapy can address a wide range of knee problems including ACL tears, MCL sprains or tears, PCL sprains or tears, rheumatoid arthritis of the knees, knee tendonitis, and patellar tendinosis [1]. For patients with complete non-retracted ACL tears, stem cell therapy offers a safe, non-surgical alternative to ACL repair that is a viable option for those considering surgical intervention [1].
MINIMALLY INVASIVE PROCEDURES
Beyond regenerative medicine, there are several other minimally invasive procedures that can help severe knee arthritis without requiring full joint replacement. One of these is genicular artery embolization, or GAE. This is a minor procedure that blocks some arteries to lower swelling in the knee [7]. For patients with moderate to severe knee osteoarthritis who are not ready or not candidates for knee replacement surgery, GAE offers a powerful alternative [11].
The way GAE works is quite different from other treatments. Instead of trying to repair the joint directly, it reduces the blood flow to the inflamed tissue around the knee, which decreases swelling and pain. When you’re ready for an arthritis treatment that goes beyond lifestyle changes or medication, genicular artery embolization can offer knee pain relief without surgery [9]. For many patients, this option can also help preserve mobility and prevent disease progression, while allowing you to delay or avoid a total knee replacement [9].
Another minimally invasive option is radiofrequency ablation, or RFA. This method kills nerves in the joint that send pain messages [7]. By interrupting the pain signals, this procedure can provide significant relief without addressing the underlying joint damage directly.
Viscosupplementation is another less invasive option. Hyaluronic acid injections can help ease pain and keep the joint lubricated, but effects may vary [7]. These injections work by providing lubrication to the joint, similar to how oil works in machinery. While the effects may not be permanent, they can provide relief for many patients.
WHY SURGERY MIGHT NOT BE THE BEST FIRST CHOICE
Recent research has actually shown that some of the most popular arthroscopic surgeries, such as meniscectomy, provide little benefit to the patient [5]. This finding has changed how many doctors approach severe knee arthritis. Additionally, knee replacement is extremely traumatic and carries risks of chronic pain and toxic wear particles entering the bloodstream [5]. Surgical risks aside, all surgeries require months of painful rehab to regain strength and mobility [5].
There is another important consideration. Most knee surgeries actually accelerate the cascade of degeneration that leads to osteoarthritis [5]. This means that having surgery might actually make the arthritis worse over time, requiring additional surgeries down the road. This is a critical point that patients should understand when considering their options.
THE RESULTS PATIENTS ARE EXPERIENCING
Physicians in the licensed Regenexx network have helped thousands of patients with arthritis avoid knee replacement and continue to do the things they love with little or no pain [3]. These are not theoretical benefits but real outcomes that patients are experiencing. The procedures have helped thousands of patients improve their quality of life, return to the activities they enjoy, and avoid the need for surgery or joint replacement [3].
Even in difficult cases, such as complete muscle and ligament tears, physicians have seen exciting results [5]. This suggests that regenerative and minimally invasive approaches are effective even in severe situations where surgery might have been the only option in the past.
WHEN KNEE REPLACEMENT MIGHT STILL BE NECESSARY
It is important to note that knee replacement surgery still has a role to play in treating severe arthritis
