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Alternatives to Knee Replacement Surgery: Comprehensive Treatment Options

Active woman jogging outdoors as part of healthy lifestyle and physical therapy options, representing alternatives to knee replacement surgery.

By Greg Takenishi, MD, FAAOS – Board-certified orthopedic surgeon with subspecialty certification in Orthopaedic Sports Medicine

Arthritis commonly affects knee joints as we age, but not everyone needs or wants a knee replacement and some people may not even be candidates for surgery. If you’re experiencing knee pain, there are many effective alternatives to knee replacement surgery that can help you maintain an active lifestyle without major surgery.

When to Consider Knee Replacement Alternatives

Typically knee replacement surgery is done for older patients that have bone on bone knee arthritis and have pain that is limiting their ability to do their activities of daily living. However, knee replacement surgery is not without its downsides and potential complications.

Important considerations about knee replacements:

  • Knee replacements typically last 10-15 years
  • Young people should avoid doing the surgery as long as possible to avoid having revision knee replacement surgery
  • Every time a knee replacement revision surgery is performed, the risk of complications increases, with increased risk of infection being one of the main concerns

This is why exploring knee replacement alternatives should be your first step, especially if you’re younger or want to maintain high activity levels.

Non-Surgical Alternatives to Knee Replacement Surgery

There are several effective non-surgical knee treatments that can help manage knee arthritis pain and improve function without surgery.

Physical Therapy and Exercise Programs

Physical therapy has been shown to be of great benefit in improving people’s mobility, strength, and helping them avoid surgery. People with significant arthritis underneath their kneecaps should avoid deep knee bending and exercises that require deep squatting.

Recommended low-impact cardiovascular exercises:

  • Stationary bike
  • Regular biking
  • Elliptical machine
  • Rower machine
  • Swimming or water aerobics

Proper cardiovascular exercise is important for overall health and helping with knees. People with knee arthritis should stick with non-impact exercising. These non-impact exercises put less force through the knee joint and allow patients to become more fit and stronger.

Weight Management: A Powerful Tool to Avoid Knee Surgery

Maintaining an ideal weight and considering weight loss is very important for all your joints and particularly for your knees. The impact of weight on knee health is dramatic:

The weight-knee force relationship:

  • Gaining 1 lb of weight increases the forces through your knee joint by four pounds of force with each step
  • Gaining 10 lbs would put 40 lb of extra force through each step
  • An average person walks 10,000 steps in a day which is equivalent to 400,000 pounds of force through your knee joint in one day

Losing weight will help reverse this process substantially, making it one of the most effective knee arthritis treatment options available.

Advanced Knee Injections

Knee injections can help with knee arthritis symptoms and are excellent alternatives to knee replacement surgery.

PRP (Platelet-Rich Plasma) Injections

The most advanced injection that has shown promise for knee osteoarthritis  is PRP which is a platelet-rich plasma that is created from the person’s own blood product. This is an all natural way to help with the discomfort in the knee. A combination of PRP and hyaluronic acid injections has proven to be the best injections for knee arthritis.

Hyaluronic Acid Injections

Hyaluronic acid injections or gel injections are a lubrication for the joint and can help with the pain. This is usually a series of 3 injections that is performed in consecutive weeks.

Cortisone Injections

Cortisone injections are another type of injection that may be recommended for temporary pain relief. The medication is a steroid that’s injected into the knee and can help with acute discomfort in the knee. However, there are important considerations:

  • Cortisone injections are not the best injections for uncontrolled diabetics because it can increase blood sugars in sensitive diabetics
  • Cortisone injections can cause degradation of the tissues and cartilage in a joint if performed too often

Knee Bracing Options

Some patients may benefit from different types of braces for the knee. Medial or lateral unloader knee braces can help offload arthritic compartments, providing pain relief and improved function.

Surgical Alternatives to Knee Replacement

When non-surgical treatments aren’t sufficient, there are several surgical alternatives to knee replacement that can preserve your natural knee anatomy.

Knee Arthroscopy

There are several different non-joint replacement type surgeries for knee arthritis. Operative management can include knee arthroscopy. This is a minimally invasive surgery that can help clean up some of the arthritis and washout the inflammatory markers within a knee joint that is caused by arthritis.

Osteotomy Surgery: Realigning Your Knee

Another type of surgery is called an osteotomy. This is a great surgery that has been performed for many decades but few orthopedic surgeons perform these types of surgeries. If one compartment of the knee is overloaded because of bone on bone arthritis, the osteotomy can realign the knee to take pressure off of the affected part of the knee.

High Tibial Osteotomy

A high tibial osteotomy is performed with people that have medial compartment arthritis.

Distal Femoral Osteotomy

A distal femoral osteotomy is performed for people that have lateral compartment arthritis.

Benefits of osteotomy procedures:

  • The surgeries are very successful in allowing people to avoid having a knee replacement and to keep their normal anatomy
  • This can allow patients to be more active and continue their heavy activities compared to undergoing a knee replacement
  • Some patients may be able to avoid having any replacement altogether by just having the osteotomy

Cartilage Transplant Surgery

Cartilage transplants can be performed for some patients that have mild to moderate arthritis. Cartilage can come from cadaver, juvenile cartilage, as well as someone’s own cartilage cells that can be regenerated. This potentially could be a possibility for someone to help preserve their knee and avoid having any replacement until later in life.

About Dr. Greg Takenishi: Your Expert in Knee Replacement Alternatives

As a board-certified orthopedic surgeon with subspecialty certification in Orthopaedic Sports Medicine, I bring unique expertise to treating patients seeking alternatives to knee replacement surgery. My experience as Head Team Physician for the Sacramento River Cats and member of the San Francisco Giants Medical Staff gives me extensive knowledge in helping both athletes and everyday patients preserve their knees.

My credentials include:

  • Board certification in Orthopedic Surgery
  • Subspecialty Certificate in Orthopaedic Sports Medicine
  • Fellow, American Academy of Orthopaedic Surgeons (FAAOS)
  • Owner, Sacramento Orthopedic Sports & Shoulder
  • Head Team Physician, Sacramento River Cats
  • San Francisco Giants Medical Staff

This sports medicine background translates directly to exceptional care for patients who want to maintain active lifestyles while avoiding knee replacement.

Frequently Asked Questions About Knee Replacement Alternatives

What are the best alternatives to knee replacement surgery?

The most effective alternatives include PRP injections combined with hyaluronic acid, osteotomy procedures for realigning the knee, comprehensive physical therapy programs, and weight management. The best option depends on your specific condition and activity goals.

Can I avoid knee replacement surgery permanently?

Many patients can delay or avoid knee replacement indefinitely through proper treatment. Osteotomy surgery, in particular, can provide years of relief while preserving your natural knee anatomy. Weight management and regular exercise also provide long-term benefits.

How effective are non-surgical treatments?

Physical therapy has been shown to significantly improve mobility and strength while helping patients avoid surgery. PRP injections, when combined with hyaluronic acid, provide excellent pain relief for many patients. Weight loss can dramatically reduce knee joint forces and pain.

Why should I see a sports medicine specialist?

Sports medicine specialists have advanced training in preserving joint function and helping patients maintain active lifestyles. My experience treating professional athletes who must avoid career-ending surgeries translates to innovative solutions for all patients seeking alternatives.

Take the Next Step: Explore Your Options

Don’t let knee arthritis limit your activities or force you into premature knee replacement surgery. As a fellowship-trained sports medicine specialist serving Sacramento and Northern California, I offer comprehensive evaluation and the most advanced alternatives to knee replacement surgery.

Contact Sacramento Orthopedic Sports & Shoulder to:

  • Explore your personalized treatment options
  • Learn about cutting-edge alternatives like osteotomy surgery and PRP injections
  • Develop a plan to preserve your natural knee
  • Get back to the activities you love

Serving Sacramento, Roseville, Folsom, and throughout Northern California

Medical Disclaimer: This information is for educational purposes only. Individual results may vary. Consult with Dr. Takenishi to determine the best treatment approach for your specific condition.

Dr. Greg Takenishi, MD, FAAOS | Sacramento Orthopedic Sports & Shoulder

Review

PRP treatment to the knee really helped relieve the pain and got me back to walking and bicycling. Great to hold off surgery. Dr Takenishi is very skilled and knowledgeable. I also love how well run the office is. Appointments run on time. His assistants are kind and personable.

Nancy Perkovich

Why Choose Us?

At Sacramento Orthopedic Sports and Shoulder, we understand the unique demands placed on athletes’ bodies and the impact of sports-related injuries. Dr. Takenishi’s expertise spans across various areas, including:

    1. Comprehensive Sports Medicine Care:
      • Dr. Takenishi has over 12 years of experience working with athletes, trainers, athletic directors, coaches and physical therapists.  He understands the team dynamics and what is necessary to reach the highest level of sport.  This enables him to effectively prevent and manage athletic injuries, guiding you through a successful recovery.
    2. Expert Shoulder Care:
      • Our practice specializes in diagnosing and treating shoulder conditions such as rotator cuff tears, frozen shoulder, shoulder instability, arthritic shoulders and shoulder impingement. Dr. Takenishi’s expertise ensures that your shoulder receives the utmost care and attention it deserves.
    3. Performance Enhancement:
      • Whether you’re a professional athlete or a weekend warrior, Dr. Takenishi is well-versed in enhancing athletic performance through conditioning, training, fitness, and nutrition guidance. He considers a holistic approach to helping athletes achieve their full potential by relying upon a team approach through any sporting injuries.  He incorporates a multifaceted approach to maximize performance and health, ensuring you are at the top of your game.  This is even more important when dealing with sporting injuries that require surgical management and a stepwise approach to getting you back on the field when you are ready.
    4. Team Approach to Care:
      • We believe in a collaborative approach to healthcare. Dr. Takenishi coordinates care with other healthcare professionals, ensuring a well-rounded and comprehensive treatment plan for your specific needs.
    5. State-of-the-Art Facilities:
      • Our clinic is equipped with advanced technology and state-of-the-art facilities, providing you with the highest standard of care in a comfortable environment.
    6. Compassionate Care:
      • At Sacramento Orthopedic Sports and Shoulder, we value your well-being above all else. Dr. Takenishi and our team are dedicated to providing compassionate care and personalized attention throughout your treatment journey.
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