For a "bone-on-bone" knee (severe osteoarthritis), treatments focus on pain relief, improved function, and delaying surgery, including lifestyle changes (weight loss, low-impact exercise like swimming/cycling), physical therapy (strengthening/flexibility), medications (NSAIDs, topical creams), injections (steroids, hyaluronic acid, PRP), braces/orthotics, and in severe cases, surgery like osteotomy or total knee replacement.
As knee arthritis progresses, the knee becomes much looser and more unstable. In some cases, this is mild. In other cases, it is substantial enough that cause the patient to fall. Patients who have bone-on-bone arthritis and are starting to fall because of it should strongly consider surgery.
Regenerative Alternatives for Bone-on-Bone Knee Pain
Platelet Rich Plasma (PRP) and Bone Marrow Concentrate (BMC) are two alternatives to surgery that can improve function and decrease pain without being as invasive as a knee replacement.
In fact, people with knee osteoarthritis who walk for exercise are significantly less likely to go on to develop worse pain, according to a 2022 study published in Arthritis & Rheumatology. Here are a few reasons why: Walking strengthens leg muscles.
When the cartilage gets damaged—either from injury or from wear and tear with age—it can start to wear away, causing the bones to rub together directly. This bone-on-bone contact causes knee pain and inflammation. Knee osteoarthritis is a degenerative knee condition that gets worse over time.
Nonsurgical osteoarthritis of the knee treatments include:
Knee replacement alternatives: genicular artery embolization (GAE) GAE is one of newest treatment options if you're seeking non-surgical knee replacement alternatives.
5 Activities to Avoid With Knee Osteoarthritis
The #1 mistake making bad knees worse is excessive rest and a sedentary lifestyle, leading to weaker supporting muscles, stiffness, and a vicious cycle of more pain; instead, gentle, consistent movement (like walking, swimming) is crucial to strengthen the joint and improve function, though it must be balanced with avoiding activities that cause sharp pain. Other major errors include ignoring pain signals, carrying excess weight, wearing unsupportive shoes, and poor movement patterns, says Parkside Sports Physiotherapy and Coastal Empire Orthopedics.
Can you walk with knee cartilage damage? Typically, you can still walk with knee cartilage damage, but it often becomes painful. Pain will likely increase going up or down stairs. If left untreated, the pain increases to the point where walking becomes progressively difficult.
These medications reduce inflammation and relieve pain. Examples of NSAIDs include diclofenac, ibuprofen and naproxen. Two other anti-inflammatory painkillers with a similar effect are celecoxib and etoricoxib. These are COX-2 inhibitors (also known as coxibs).
Constant pain
One of the main signs a knee replacement is needed is severe and prolonged pain in the knee and the surrounding area. This pain can also be present elsewhere such as the hip or ankle, which impacts your daily life even when you are resting.
Adjust your sleeping position
“If you sleep on your side, place a pillow between your knees to reduce pressure on your joints,” says Dr. Burns. “If you prefer to sleep on your back, try sliding a small pillow or rolled towel under the knees for support.” But if you're a stomach sleeper, be careful.
Surgeons have performed knee replacements for over three decades generally with excellent results; most reports have ten-year success rates in excess of 90 percent.
Gel Shots for Knees (Viscosupplementation/Rooster Comb Injections) Gel shots are treatments that contain hyaluronic acid — a substance normally found in the knee that acts like a shock absorber and lubricates the joint. People with osteoarthritis have less of this natural gel than they should.
Like Spring, Autumn is a good time of year to undergo knee replacement surgery. The temperatures make sleeping far easier, while the nights are lighter, making exercise more accessible.
What exercises can help prevent or manage knee pain? Walking is excellent exercise, not only for the knee, but also for the cardiovascular system. Many cardiologists suggest that a brisk 30 minute walk three times a week is more beneficial for the heart than high intensity gym exercises.
Identifying Knee Pain Red Flags
Severe swelling: If your swollen knee feels warm and looks red, it might be a condition requiring medical evaluation. Inability to bear weight: If you have difficulty putting weight on your knee, it may indicate a serious injury.
Here are some key supplements you may want to consider adding to your health regimen to relieve joint pain.
While surgical intervention, such as knee replacement, may be necessary for severe cases, there are several non-surgical treatment options available that can help manage the condition and provide relief from the associated pain. One non-surgical treatment option that has shown promising results is viscosupplementation.
Foods to Avoid
To know what to eat for dry knee joints, take a look at the following food list:
ZILRETTA is the first and only FDA-approved treatment for osteoarthritis (OA) knee pain that uses extended-release microsphere technology.
Research suggests that up to one-third of those who have knees replaced continue to experience chronic pain, while 1 in 5 are dissatisfied with the results.
Here are five minimally invasive options you and your orthopedic surgeon can try before committing to knee replacement surgery: