How To Postpone Knee Replacement Surgery

By Dr. Ro Mahajan, MD

Knee replacement is the most commonly performed orthopedic surgery in the United States. Many consider it a last-resort treatment for osteoarthritis of the knee — a degenerative condition that causes the cartilage within the joint to break down over time.

But that’s not always the case.

While osteoarthritis (OA) can begin as early as age 35 due to natural wear and tear, its progression can be accelerated by factors such as high-impact sports, previous injuries, obesity, and abnormal biomechanics caused by gait abnormalities or other musculoskeletal conditions.

The resulting pain is typically worse after periods of inactivity and can significantly impair mobility and daily function. As arthritis advances, it may even lead to leg misalignment, which can further exacerbate joint damage and discomfort.

This is why some experts might push knee replacement surgery earlier than others. As a result, some patients may believe it’s their only viable option.

The good news is that there are many non-surgical strategies that can help manage knee arthritis, reduce pain, and potentially delay — or avoid altogether — the need for surgery.

Let’s start with some of the most common and conservative non-surgical strategies for managing knee osteoarthritis — and postponing knee replacement surgery.

Non-Surgical Strategies for Managing Knee Osteoarthritis

Weight Loss

Weight loss is perhaps the single most effective way to slow the progression of knee osteoarthritis and relieve pain.

Research shows that for every pound of weight lost, there is approximately a four-pound reduction in pressure on the knees during activity. If you are overweight or obese, even modest weight loss can yield meaningful improvements in knee pain — and in overall health.

Medications

Acetaminophen (Tylenol) is often used as a first-line treatment for knee arthritis pain. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) or naproxen (Aleve), may also be helpful. But these medications carry risks — especially with long-term use — such as gastrointestinal, kidney, and cardiovascular side effects.

Always consult your physician before starting regular use of these medications. (And if you’re looking for natural alternatives to NSAIDs, here are three of the best.)

Physical Therapy

Working with a licensed physical therapist can be one of the most impactful and sustainable ways to improve knee function and reduce pain. Strengthening the quadriceps and surrounding muscles helps offload pressure from the knee joint, stabilizing the area and reducing further wear. I’ve seen many patients avoid surgery by simply committing to a structured physical therapy program.

Conventional Medical Interventions

When conservative approaches no longer provide adequate relief, the next tier of treatments often includes:

Corticosteroid Injections

These help reduce inflammation and provide temporary pain relief. But repeated use can be detrimental to cartilage health. (You can read more about my thoughts on these injections, as well as three of my favorite natural alternatives, HERE.)

Hyaluronic Acid Injections

This synthetic lubricant may help some patients by improving joint mechanics, though results typically take 3-4 weeks to appear and are not guaranteed.

Knee Replacement Surgery

Yes, this is the intervention we’re hoping to postpone (or avoid). However, in the case of severe arthritis, this can be the most effective course of action. That said, this is a major procedure that involves substantial recovery time (typically six weeks or more). It also carries a notable risk of ongoing pain. Studies show that up to 20% of patients report persistent pain after knee replacement surgery.¹

Regenerative and Alternative Therapies

For patients seeking to delay or avoid knee replacement — and who do not yet have severe deformity or bone-on-bone arthritis — there are several emerging and complementary options that may be beneficial:

Platelet-Rich Plasma (PRP) or Stem Cell Therapy

These biologic treatments aim to harness the body’s natural healing potential to reduce inflammation and support tissue repair. PRP has shown promise in mild-to-moderate knee OA, especially in patients under 65.

High-Intensity Laser Therapy

This non-invasive therapy uses light energy to stimulate cellular repair and reduce inflammation. It can provide pain relief and help improve mobility for some patients.

Shockwave Therapy

Originally used in sports medicine, this modality uses acoustic energy to stimulate healing. While more commonly used for tendon conditions, some patients with knee arthritis have reported improvements in pain and function.

My Approach as a Regenerative Medicine Physician

In my practice, I aim to help patients reduce pain, maintain function, and avoid unnecessary surgery using the safest and least invasive treatments available.

For those looking to delay or avoid knee replacement surgery, I often recommend a comprehensive strategy that includes:

• Weight loss (if appropriate)

  
  

• Regular physical therapy

  
  

• Targeted regenerative medicine therapies

From there, if necessary, more drastic interventions — suchas corticosteroid injections or even surgery — might be worth considering.

Putting It All Together

Every patient is unique.

The key is to work with your healthcare provider to build a personalized treatment plan that targets the underlying biomechanics, reduces inflammation, and helps preserve your joint health for as long as possible.