What are the alternatives to knee surgery?

Knee joint replacement surgery is only offered when other treatments such as physiotherapy haven't worked. Here are some common questions people ask about alternatives to knee surgery.

On this page, you will find information on:

  1. What can I do to prevent knee pain?
  2. What can I do if I have knee pain?
  3. Is there anything I can do to prevent having knee surgery?
  4. When is surgery a good option? 
  5. What can I do if I am on a waiting list and still have pain?
  6. What if surgery is not an option for me and I need to live with pain long term?

What can I do to prevent knee pain?

There are things you can do to help protect your knee and prevent knee pain. 

  • Have a healthy balanced diet and maintain a healthy weight – this means you don't put extra stress on your knee joints and so it helps prevent knee pain.
  • Do regular exercise – this helps strengthen the muscles around your knee and promotes joint flexibility and mobility. 
  • Wear well-fitted and supportive footwear – this helps distribute the pressure on your knee appropriately and prevents you from sliding on slippery surfaces, which can injure your knee. 
  • Avoid repetitive kneeling or kneeling on hard surfaces – this can damage the protective cushion in your knee (bursa) and cause knee pain. If your job or other regular activities involve frequent kneeling, wear knee pads or protective cushions on your knee to help prevent damage to the bursa and ligaments around your knee. 

What can I do if I have knee pain?

If you have knee pain, you can do the following things to reduce the pain:

  • Regular exercise – although you may tend to avoid doing exercise when you have knee pain, regular exercise and staying active can help reduce your pain. Exercises such as swimming, cycling or walking are particularly good for your knee. They are low impact and don't stress the joint but help keep your muscles healthy and strong. 
  • Lose weight – being overweight can put extra strain on your knees, increasing your pain and make it harder to exercise. Losing even a small amount of weight can greatly reduce knee pain.
  • Physiotherapy or occupational therapy – a physiotherapist can help plan and recommend suitable exercises for you to lessen your knee pain. An occupational therapist can teach you things such as how to pace your activities and spread hard jobs throughout the day to reduce extra strain on your knee. 
  • Pain relief medicines – pain relief medicines or painkillers are often recommended by your doctor or pharmacist to reduce pain and stiffness. All medicines should be used at appropriate doses and for the shortest duration possible. Examples of pain relief medicines include paracetamol, NSAIDs or capsaicin creams and gels. Ask your doctor or pharmacist if you are unsure about which type of pain relief medicines is suitable for you. 

Is there anything I can do to prevent having knee surgery?

The treatment of knee pain is different for everyone. If you are overweight, weight loss is especially helpful and may mean you no longer need surgery.

You may be able to find a combination of the treatment options above that works for you without needing to have surgery. Having support from your family/whānau and friends also help as being anxious and depressed can make your pain worse. 

When is surgery a good option?

Most people with knee pain don't need surgery. However, surgery is a good option and is offered when the treatment options above don't work. Usually, knee surgery will be recommended by your doctor if:

  • your knee hurts most of the time and stops you from sleeping
  • you are unable to carry out daily activities
  • your knee pain is making you depressed
  • you become dependent due to your knee pain 
  • your knee keeps giving way or locking up
  • the treatment options above don't work for you.

What can I do if I am on a waiting list and still have pain?

Your doctor or surgeon will make a plan with you on the things you can do when you are on a surgery waiting list.

They may refer you to an physiotherapist to assess your mobility and independence and an occupational therapist to help you get on with your daily activities. You may also need to take pain relief medicines to help cope with your pain while waiting for surgery.

If you are overweight or obese, losing weight helps to remove the extra strain on your knees. Your doctor may also recommend suitable exercises for you to help maintain your mobility. 

What if surgery is not an option for me and I need to live with pain long term?

If surgery is not an option for you, there are many other treatment options available. You may find a combination of these treatments helpful. Talk to your GP or doctor to find out the best treatment options for you. 

Treatment options can include the following:

  • Low impact exercise – regular exercise and staying active can help reduce your pain. Exercises such as swimming, cycling or walking are particularly good for your knee. They are low impact and don't stress the joint but help keep your muscles healthy and strong. 
  • Complementary or alternative therapies – complementary or alternative treatments are not usually recommended in the treatment of osteoarthritis, due to a lack of quality evidence or evidence that they are ineffective. Some people may find them beneficial, possibly due to a placebo effect. Examples of therapies include acupuncture, heat or cold pack or transcutaneous electrical nerve stimulation (TENS). Read more about complementary or alternative therapies
  • Losing weight – being overweight can put extra strain on your knees, increasing your pain and make it harder to exercise. Losing even a small amount of weight can greatly reduce knee pain.
  • Physiotherapy or occupational therapy – a physiotherapist can help plan and recommend suitable exercises for you to lessen your knee pain. An occupational therapist can teach you things such as how to pace your activities and spreading hard jobs throughout the day to reduce extra strain on your knee. 
  • Pain relief medicines – pain relief medicines or painkillers are often recommended by your doctor or pharmacist to reduce pain and stiffness. All medicines should be used at appropriate doses and for the shortest duration possible. Examples of pain relief medicines include paracetamol, NSAIDs or capsaicin creams and gels. Ask your doctor or pharmacist if you are unsure about which type of pain relief medicines is suitable for you. Read more about medicines for osteoarthritis
  • Joint injections or other types of surgery – joint injections such as steroid injections can help reduce inflammation and pain in your knee whereas hyaluronic acid injections can help lubricate your knee. Other types of surgery include arthroscopic surgery and osteotomy. Ask your doctor to find out more details and whether these treatments are available in your area. 
  • Mobility aids and devices – there are many different mobility aids and devices available to help you get around, such as walking sticks, walking aids and shock absorbing shoes. There is also mobility parking available for you to use – car parks that are wider than normal parks and closer to venues. Ask your doctor to find out what is available in your area. 

Learn more

The following links provide further information about alternatives to knee surgery. Be aware that websites from other countries may have information that differs from New Zealand recommendations. 

Is a knee replacement right for you? Ministry of Health, NZ
Osteoarthritis Health Navigator, NZ
Arthritis – exercises to keep you moving Arthritis NZ
Osteoarthritis NHS, UK
Knee pain Versus Arthritis, UK
Knee replacement alternatives to consider Johns Hopkins Medicine, US
5 alternatives to knee replacement Mayo Clinic Health System, US

References

  1. Is a knee replacement right for you? Ministry of Health, NZ
  2. Osteoarthritis NHS, UK
  3. Knee replacement alternatives to consider Johns Hopkins Medicine, US

Reviewed by

Dr Helen Kenealy is a geriatrician and general physician working at Counties Manukau DHB. She has a broad range of interests and has worked in a variety of settings including inpatient rehabilitation, orthgeriatrics and community geriatrics.
Credits: Health Navigator Editorial Team. Reviewed By: Dr Helen Kenealy, geriatrician and general physician, Counties Manukau DHB Last reviewed: 18 Dec 2020