Knee Replacement: Identifying Patient Options to Guide Innovative Treatments
By Dr. Joseph Mejia, DO, FAAPMR
Medical Director, Performance Ortho
Severe Knee Pain Limits Daily Life
As one of the main weight bearing joints in the body, your knees are particularly susceptible to overuse and stiffness, and as a result, chronic pain. As with most orthopedic conditions, chronic knee pain is often attributed as a sign of aging, however sports injuries and personal health can lead to conditions such as bursitis, osteoarthritis, runner’s knee and more.
Chronic knee pain can greatly hinder quality of life, limit mobility and keep those who are struggling off their feet. In extreme cases, knee degeneration may be so severe that complete knee replacement is a patient’s only recourse towards long-term recovery, which is accompanied with intensive rehabilitation and medications.
At Performance Ortho, we aim to explore all minimally-invasive solutions, when possible, to keep our patients out of surgery and accelerate recovery towards independence.
Advanced Joint Damage Seen on Imagery
Knee imaging is an essential tool at Performance Ortho in guiding our diagnosis and subsequent treatment avenues. This diagnostic imaging is done on sight by our board-certified physicians, which means no waiting for results. Typically, clinicians will utilize a standing X-ray to look for cartilage loss and joint space narrowing (osteoarthritis), alongside diagnostic ultrasounds to evaluate for joint swelling and supporting tendon and ligament issues. In more complex presentation, the physician may order an MRI.
The severity of degeneration in the knee will likely guide the direction of each patient’s individual treatment plan. For cases with more advanced degeneration and higher pain levels, intervention to control pain may be necessary in the form of anti-inflammatory injections, local nerve blocking, or ablations. Often an assisted device like a knee brace other medical equipment to stabilize the joints and reduce risk of further damage or injury may be recommended.
Personal health and lifestyle changes may also be immediately recommended to lessen the stress on your joints and prevent further damage. This will likely include diet changes and low-impact exercise activities. From this point, many practices will explore over the counter medications, cartilage replacement, advanced surgical intervention and even full knee replacements.
At Performance Ortho, we exhaust non-surgical interventions and develop multi-disciplinary treatment plans which are customized for each patient before making any decisions on invasive treatment, with the goal of walking alongside each patient and helping them navigate their own healthcare options to fit their personal needs.
“Bone on Bone” Knee Findings – A Word of Caution
Dr. Mejia explains, a “common phrase I see on knee X-ray reports is ‘bone on bone.’ While this sounds definitive, it is often overstated and can be misleading. The degree of joint space narrowing is only one factor, and not always the most important, when determining the best treatment plan.”
“I have seen patients with advanced ‘bone on bone’ changes who experience minimal pain and do very well with conservative treatments, such as injections, stem cells, bracing, activity modification, or physical therapy. On the other hand, I’ve also seen patients with only mild narrowing who struggle with significant pain and limited function, requiring more advanced interventions like total knee replacement to find relief.”
“That’s why it’s important to remember: an X-ray alone cannot decide whether surgery is necessary. Pain levels, range of motion, prior treatments, and the overall impact on quality of life all need to be carefully weighed before recommending the right course of care.”
Where Knee Replacement Surgery Sometimes Falls Short
For most, a major barrier for knee replacement surgery is recovery and healing time. It can take a minimum of 12 months post-surgery for a complete return to activity. Even with this timeframe, complications or improper post-operative therapy may cause delays or even create a necessity for revisionary procedures.
Like any surgery, there are also general complication risks as well such as blood clots, infection and anesthesia. Depending on age and health at the time of operation, knee replacement surgeries can be temporary with prosthetic instability and shifting over time requiring revisional procedures.
Non-Surgical Treatment Options for Knee Pain
A Unique, Team-Based Approach to Knee Pain
At Performance Ortho, what makes us unique is our team-based approach to orthopedic conditions, including knee pain. Unlike practices where you see one provider at a time, each patient at Performance Ortho is evaluated by a coordinated team of specialists in one location, which includes:
- Orthopedic Surgeons – to assess structural concerns and discuss surgical options when appropriate.
- Physical Medicine & Rehabilitation Physicians – specialists in non-operative treatments such as injections, bracing or advanced therapies.
- Rehabilitation Specialists – physical and occupational therapists who focus on restoring strength, mobility and function.
This collaborative model ensures that every patient receives a comprehensive, personalized care plan. By aligning expertise across specialties, we’re able to accelerate results, reduce downtime, and create a synergy that improves outcomes.
For knee pain, this means you’ll not only have access to advanced diagnostics and a variety of non-invasive treatment avenues, but also the confidence that your care is guided by a team working together with your best outcome in mind.
Typically, initial treatment focuses on acute pain relief through interventions such as focused shockwave therapies, ultrasound-guided “gel “injections with ant-inflammatory injections. Additionally, regenerative medicine (Platelet Rich Plasma, Stem Cell Therapy) is used to naturally heal joint degeneration, simulating the body’s natural healing potential to reduce inflammation and restore health within joint tissues. If patient’s respond successfully to these non-surgical interventions, their care plan would then be coupled with rehabilitative therapy to improve strength, flexibility and stability in the knee.
Contact Performance Ortho for More Information
If you or a loved one is struggling with chronic knee pain and contemplating replacement surgery, or are just confused on what your options are, we implore you to give us a call and book a consultation. Contact one of our four New Jersey ortho clinics in Branchburg, Somerset, Watchung, and Hillsborough. Our compassionate team and their expertise are here to help you through every step of your journey to pain relief.