14 alternatives to knee replacement surgery in 2021 (2023)

  • gold injections
  • stem cell therapy
  • PRP-Therapie
  • Prolotherapie
  • HLA injections
  • medication
  • Corticosteroids
  • Acupuncture
  • physical therapy
  • Assistive Aids
  • Ancient medicine
  • Alternate Operations
  • Bariatric procedure
  • comparison of alternatives
  • Futile options
  • HLA vs. The gold injection
  • Diploma

Does joint pain, swelling and stiffness keep you from doing many everyday tasks? While your arthritis shouldn't prevent you from living life fully, unfortunately it does! In addition, the thought of invasive surgery can be excruciating. If so, new knee replacement alternatives can help you and your loved ones.

14 alternatives to knee replacement surgery in 2021 (1)

We examine fourteen different options for improving the health of an arthritis sufferer. You will see a range of home remedies to conventional methods to new age non-surgical solutions. Of these, you can choose to trust the one that feels and fits best.

Advanced alternatives to knee replacement

1. Gold Injections - We Bet You Didn't Know About It!

This new gold microbead injection is a drug delivery system developed by US and Danish scientists. After many animal and human studies, it was launched in 2017. APilot studyalso shows the success of this therapy.

  • How does the new gold syringe treat osteoarthritis pain?

How does the new gold syringe treat osteoarthritis pain?

Gold injections disrupt the zinc-based pain pathways, resulting in a reduction in pain. Still, this injection doesn't just provide symptomatic relief! It actually works on the underlying condition that is causing the pain.

macrophage immune response

Macrophages are white blood cells that are recruited by the body to help clear foreign particles that cause infection. Research confirms this anti-infection mechanism of macrophages.[1]NCBI Targeting of macrophages as a potential therapeutic intervention "The well-known bipolar model [4,5] distinguishes macrophages into two main subgroups: pro-inflammatory (M1, classically activated via interferon-γ) and anti-inflammatory." View in article

Gold microbeads induce an immune response

The body recognizes gold beads as foreign objects and recruits macrophages to eliminate them. The macrophages attack the gold microbeads and release the gold ions.

Gold ions block pain pathways

The gold ions block the zinc-oriented pain pathways. Now the brain stops receiving pain signals. Once the pain stops, the edema also goes down.

Gold is becoming sluggish again

Because macrophages are no longer active, the gold microbeads stop releasing gold ions and go back to the inert state. For this reason, "You get what you need and in the right quantity", like Dr. Robert quoted.

The procedure

You will receive an intra-articular (IA) injection of 20 mg gold microbeads into the affected knee joint. Ideally, you will notice pain relief after about a day. However, an immediate improvement in your gait is visible within 1-2 hours.

Therefore, it is an on-demand pain reliever. If there is no inflammation, these injected particles remain inert.

Old vs. New Gold Injections

Not to be confused with older DMARD gold injections for rheumatoid arthritis!They reduce the immune system response. Therefore, older gold injections cannot be a long-term treatment due to the increased risk of infection.Connect with our teamto learn more about the new gold therapy.

Summary of new gold injections for osteoarthritis!

The new approach brings with it a number of advantages and disadvantages. Despite the disadvantages, you will find that the results are quite reliable. Check out this list to learn the benefits, risks, and expected results of the latest treatment option:


  • Non-Invasive - No scarring, less pain
  • No blood transfusion – Low risk of infection
  • Not immunosuppressive - no risk of infection
  • Pure Gold - Non-toxic, unlike other gold injections
  • One session (less than 30 min) - time saving
  • Unique – Saves costs and time
  • Fast Acting - Fast Recovery
  • Low Cost - Save money


  • Not yet approved by the FDA
  • Long-term results not available
  • Long-distance travel to Mexico


  • Reduced friction between bones during movement
  • Relieves knee pain
  • Reduce inflammation and swelling
  • Provide long-term relief
  • Improves joint mobility

Not sure if you want to do it? Have your case medically reviewed by our medical team.connect with usand use yoursfirst virtual consultation with the doctor free of charge.

(Video) Not Just A Total Knee Replacement - The alternatives for OA

2. Stem Cell Therapy

Research shows that stem cell therapy improves cartilage quality. In addition, it provides pain relief and a better quality of life.[2]NCBI Bone marrow derived stem cells in knee osteoarthritis "Reduced pain, minimized morbidity at the donor site, improved quality of life..." View in articleBut this treatment is not yet part of the medical standard. There is no standardization regarding the source and dose of stem cells.

Therefore, researchers recommend an in-depth study to derive the optimal dose. They also recommend standardizing the methodology.[3]NCBI Stem cell treatment for the knee "Future research directions should include work to elucidate the optimal cell concentration and dosage, and to standardize the methodology." View in article

3. Platelet rich plasma (PRP) therapy.

Platelets are rich in growth factors and therefore help in the treatment of the knee. PRP therapy consists of three steps:

Step 1: Draw blood from the patient

Step 2: Extract platelets from whole blood

Step 3: Injection into the knee joint

Research suggests that PRP injections may reduce knee pain and inflammation.[4]Journal of Orthopedic Surgery and Research Platelet-rich plasma therapy for knee osteoarthritis "Pain symptoms and severity of clinical osteoarthritis symptoms decreased." View in articleExisting guidelines from the National Institute for Health and Care Excellence (NICE) also report no major safety concerns.[5]PRETTY Guide to Interventional Procedures "Current findings on injections of platelet-rich plasma in knee osteoarthritis do not raise any major safety concerns." View in article

But evidence of its effectiveness is insufficient and requires more research. It also lacks standardization in itspreparation and administration.

4. Prolotherapie

In prolotherapy, the doctor injects glucose solution into the affected area. This solution stimulates the healing step by increasing blood flow to that area.

Research shows that prolotherapy reduces pain and stiffness. In addition, you can see a constant and significant improvement in joint function.[6]Journal of Orthopedic Surgery and Research Platelet-rich plasma therapy for knee osteoarthritis “WOMAC pain -5.41, 0.61, <0.001; WOMAC Stiffness -1.76, 0.31, < 0.001” View in article

Although this procedure is safe, it requires more research. As such, the 2019 Arthritis Foundation guidelines do not recommend its use.[7]Arthritis Foundation Prolotherapie bei Osteoarthritis "I would not recommend prolotherapy because I believe the jury is still out on its effectiveness," says Julius Oni, MD, assistant professor of orthopedic surgery at Johns Hopkins University School of Medicine in Baltimore, Maryland. View in articleYou should follow your doctor's advice to see if this can help you.

5. Hyaluronic acid (HLA) injections.

HLA injections can help with:

  • Lubricate the knee joint
  • improve shock absorption
  • reduce pain
  • Improve joint mobility

Although the results look promising, they could use more research. There is insufficient evidence of its effectiveness. As such, the Arthritis Foundation guidelines do not currently recommendtheir use.[8]Rheumatology consultant 2019 ACR/Arthritis Foundation Guidelines “Intra-articular hyaluronic acid injections are strongly recommended in patients with hip osteoarthritis. The evidence on the lack of benefit of hyaluronic acid injections in hip OA is of higher quality.” View in article

Hyaluronic Acid (HLA) Vs. Gold Injection

The gold injections compared to HLA, may be a better alternative for you. Doctors use HLA injections for symptomatic pain relief in osteoarthritis patients. Gold injections, on the other hand, focus on treating the subsoilcondition for OA.

(Video) 7 Most Common Symptoms of Loose Knee Replacement

Conventional knee replacement alternatives

6. Medication

NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) can reduce pain, inflammation, and swelling. But its prolonged consumption can cause stomach ulcers, kidney damage, and gastrointestinal bleeding.[9]NCBI medication for osteoarthritis "All nonsteroidal anti-inflammatory drugs (NSAIDs) have the potential to cause side effects...including gastrointestinal (COX-1) ulceration and bleeding, high blood pressure and kidney damage." View in articleAnother option may be over-the-counter (OTC) medications.

7. Steroidspritzen

Corticosteroid administration can reduce knee pain and inflammation. The pain relief lasts for several weeks. The Arthritis Foundation 2019Guidelines recommend their use.[10]Rheumatology consultant 2019 ACR/Arthritis Foundation Guidelines "Topical NSAIDs are conditionally recommended for patients with osteoarthritis of the hand." View in article

8. Therapeutic option - acupuncture

Acupuncture uses thin, sharp needles to alter the flow of energy in the body. It relieves joint pain and has low risk. However, research suggests that comfort lasts only in the short term.

In addition, it can improve short- and long-term physical function.[11]PubMed The effects of acupuncture on chronic knee pain “The acupuncture groups demonstrated superior pain improvement and physical function in the short term (up to 13 weeks). The acupuncture groups demonstrated superior physical function over the long term (up to 26 weeks), but not superior pain relief.” View in articleHence the 2019 arthritisFoundation policies support its use.[12]Rheumatology consultant 2019 ACR/Arthritis Foundation Guidelines "Acupuncture is conditionally recommended for patients with knee, hip, and/or hand OA." View in article

9. PhysiotherapyYoga and other exercises

Physiotherapy aims to relieve pain and strengthen the knee muscles. A physical therapist will guide you to ensure you are doing the exercises correctly.

The therapeutic approach may include

  • Ice and heat application
  • Neuromuscular Training
  • strengthening exercises
  • stretching

You should avoid twisting and running as this can worsen the knee injury. Reduce activities like climbing stairsor squats can also help. Check out this 15 minute yoga routine for your knees. It avoids the struggle you may face when doing squats, lunges, and bends!

(Video) Exercises 12 Weeks After Surgery - Total Knee Replacement

Knee-friendly yoga from MSUNN Yoga & Wellness

10. Aids

Aids are walking sticks and orthoses. These devices perform the following functions:

  • Strengthening of the knee muscles
  • improve mobility
  • Better stability and support
  • Helps prevent knee pain and inflammationbecome worse.

11. Alte Medizin (Ayurveda)

Allopathy can have side effects, but Ayurveda does not. Ayurveda begins to reduce arthritic symptoms after three months. In addition, it can help prevent the disease from progressing naturally. Therefore, it's a slow but sure treatment option that might work for you.

The Ayurveda treatment includes the combination of massage, meditation, exercise and a nutritional diet. However, it is an individual treatment according to the patient's condition.

Ayurveda naturally revitalizes damaged cartilage and prevents further deterioration of the knee joint. A PubMed research article shows that Ayurveda significantly reduces knee pain and improves the kneeFunction.[13]PubMed Ayurvedic medicine...knee osteoarthritis "Ayurvedic formulations (particularly SGCG) significantly reduced knee pain and improved knee function." View in article

12. Surgical alternative: osteotomy

During the osteotomy, the affected part of the knee is relieved. Therefore, this shift in weight helps in relieving symptoms. This procedure helps when there is less damage on only one side of the knee. However, it tends to work in younger people.

13. Surgical alternative: arthroscopy

Arthroscopy can repair a torn meniscus, ligaments, bone, or cartilage in the knee. It involves using a camera inserted through small incisions. Still, this technique may not help all types of knee problems. It is possible to go home a few hours after the procedure.

Recovery is comparatively quick. Both procedures can delay or end the needKnee replacement surgery.

14. Weight loss strategy

Obesity can put undue stress on the knee joint. Studies show that every 10 pounds you gain increases your risk of developing knee osteoarthritis by 36%.[14]NCBI High weight loss in older adults with knee osteoarthritis "These results suggest that a 10% weight loss in an overweight and obese population with osteoarthritis elicits positive changes in the mechanical pathway to knee osteoarthritis..." View in articleSo, losing 10 pounds can mean you have to use 4 times less force on your knees.

Bariatric Surgerycan also reduce excessive stress on weight-bearing joints, which can reduce osteoarthritic symptoms such as walking and joint problemsPain.

A comparison of alternatives to knee replacement surgery

Gold injection
First knee: $10,000; Thereafter: $5,000 per joint2-3 weeksNONO
stem cell therapy
$4.600 – $6.200

4-6 weeks

Platelet rich plasma (PRP) therapy.
$350 per session4-6 weeksNOYes I)
$100 - $200 per sessionImmediatelyNOYes I)
HLA injections
$310 per sessionImmediatelyNOYes I)
>15 $ImmediatelyNONO
$98 – $110 per session1-6 weeksNOYes I)
$75 - $100 per session1-4 weeksNOYes I)
physical therapy
$97 – $129 per sessionMinimum. 6 weeksNONO
Assistive Aids
$40 (cane) – $1,700 (braces)N / AN / AN / A
$60 - $100 per sessionMinimum. 12 weeksNONO
<$4.12512-24 weeksAndI (G)
$3.700 – $6.0006-8 weeksAndI (G)
knee replacement surgery
≥20.000 $6-12 weeksAndI (G)
*G: general anesthesia; L: local anesthesia

In comparison, you can see that several methods have similar recovery times. However, the length of time the result lasts may vary. For example, long-lasting results are expected from gold injections. However, the HLA injections only last 3-5 weeks.

Options that don'tWork

The 2019 Arthritis Foundation Guidelines[15]Rheumatology consultant 2019 ACR/Arthritis Foundation Guidelines “Thermal interventions (locally applied heat or cold) are conditionally recommended for patients with knee, hip, and/or hand OA. Paraffin, an additional method of heat therapy for hands, is conditionally recommended.” View in articlerecommend people not to use:

  • Modified shoes and insoles
  • Paraffin
  • biologics
  • Iontophorese
  • Kinesio-Taping
  • Bisphosphonate
  • Chondroitin Sulfate and Glucosamine Supplements
(Video) Chronic Knee Pain After Knee Surgery Longer Than 12-months
  • Colchicine
  • methotrexate
  • Hydroxychloroquin
  • Radiofrequenz-Ablation
  • Gepulste Vibrationstherapie
  • Tramadol-Opioide
  • TENS (Transcutaneous Electrical Nerve Stimulation)
  • What is the right time for knee replacement surgery?

What is the right time for knee replacement surgery?

Have you tried most of them? Do you notice a significant improvement in your symptoms? If not, you can probably consider knee replacement surgery.

Your doctor may recommend total knee replacement (TKR) or partial knee replacement (PKR). It varies depending on the case. You canconnect with usto find a licensed and famous surgeon abroad for free.

The conclusion

As you can see, these alternatives are not only inexpensive, but also provide symptom relief. In addition, knee replacement surgery carries many major risks. If so, why not give it a try?

Ultimately, you and your doctor should determine the best possible option. However, remember that there is a great chance of returning to your pain-free mobile life without a knee replacement.

(Video) What to Expect After Knee Replacement Surgery (Days 1 to 365 TKR Recovery)


What is the newest alternative to knee replacement? ›

What is the newest alternative to knee replacement?

Can anything be done instead of knee replacement? ›

Can anything be done instead of knee replacement?

Is there a future knee replacement without surgery? ›

Is there a future knee replacement without surgery?

What can be done for bone-on-bone knees without surgery? ›

What can be done for bone-on-bone knees without surgery?


1. What is Total Knee Replacement (TKR) surgery? (In Hindi) - Patient education video
(Dr Taufiq Panjwani)
2. How Young is TOO YOUNG for Knee Replacement?
(Knee Replacement Therapists)
3. Knee Replacement Surgery - What you need to know before, during and after
(Horizon Health Network - Réseau de santé Horizon)
4. How to Sleep after Knee Surgery | Knee Replacement, Injury or Surgery
5. Front of Knee Pain After Knee Replacement Surgery
(Total Therapy Solution - Physical Therapy)
6. Why you should be optimized for surgery. Not just cleared for a total knee replacement.
(Dr. Adam Rosen -Total Knee Information & Exercises)


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