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Mesa Knee Evidence Room
A clear reading of knee-care trials for Mesa

Mesa Knee Evidence Room

Answers to common questions about a sore knee

These are straight answers about easing soreness and considering surgery. The right choice depends on your exam, health, daily limits and goals. Take any question left unanswered to a clinician who can examine your knee.

Is there a better option than knee replacement?

Sometimes. Exercise, a cane, a fitted brace or medicine may improve comfort and movement. Replacement may offer more when severe soreness remains after sound non-surgical care. An exam helps match the choice to your knee and daily limits.

What is the new treatment instead of a knee replacement?

There isn't one new procedure that replaces every knee operation. PRP stands for platelet-rich plasma, the liquid part of your blood prepared with more tiny clot-making pieces called platelets. A provider spins your blood and then places that prepared portion into the knee. Human studies have found mixed results.

Are there any treatments that actually regrow cartilage?

No routine procedure has shown that it rebuilds a worn arthritic knee. Soreness can improve even when the smooth joint surface hasn't grown back. Feeling better and rebuilding tissue are different results. Ask exactly what a proposed treatment has shown in people.

Can an unloader knee brace help?

It may help when wear is worse on one side of the knee. The brace shifts pressure toward the other side while you stand and walk. It won't suit every knee, and it must feel comfortable enough to wear. An exam and X-ray can show whether pressure is on the sore side.

Does genicular artery embolization, which blocks small knee blood vessels, help soreness?

The benefit remains uncertain. In one human trial, people improved after both the artery procedure and a sham, meaning a convincing imitation that didn't block the vessels. The real procedure wasn't clearly better. Ask about risks, cost and how a clinician would judge improvement.

Is knee arthroscopy, keyhole surgery that trims torn tissue, worth it for age-related wear?

Usually not for gradual wear alone. Human studies didn't find a lasting advantage over strong non-surgical care or sham surgery, which only imitated the operation. A sudden injury or truly locked knee is different and needs an exam. The reason for surgery matters more than the small cuts.

When is a knee replacement necessary?

No single X-ray or soreness score makes surgery necessary. Replacement makes more sense when daily movement is badly limited and good non-surgical care hasn't helped. The exam findings must agree with your symptoms. Your health, goals and recovery needs also belong in that discussion.

Can I keep hiking and golfing with knee arthritis?

Often, if the knee settles after activity and stays steady. Shorten the distance, use poles or a cart, and build strength slowly. Stop for locking, buckling, marked swelling or trouble bearing weight. QC Kinetix offers consultations and regenerative treatment options such as PRP, which medical providers make from your spun blood and place in the knee.

Sources

  1. OARSI 2019 designates arthritis education plus structured land-based exercise (with or without dietary weight management) as CORE treatments for knee OA, and education plus structured land-based exercise as core for hip and polyarticular OA. Topical NSAIDs are strongly recommended for knee OA (Level 1A). Intra-articular corticosteroids and hyaluronic acid are Level 1B/2 for knee OA depending on comorbidity and are NOT recommended for hip or polyarticular OA. Oral NSAIDs are not recommended for people with cardiovascular comorbidity or frailty, and oral and transdermal opioids are strongly not recommended (Level 5).

    Bannuru RR, Osani MC, Vaysbrot EE, et al. — OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis.. Osteoarthritis and Cartilage, 2019. DOI: 10.1016/j.joca.2019.06.011.

  2. The 2019 ACR/Arthritis Foundation guideline makes STRONG recommendations for exercise, weight loss in people with knee and/or hip OA who are overweight or obese, self-efficacy and self-management programs, tai chi, cane use, tibiofemoral bracing for tibiofemoral knee OA, topical NSAIDs for knee OA, oral NSAIDs, and intra-articular glucocorticoid injections for knee OA. Radiofrequency ablation for knee OA, acupuncture, thermal modalities, acetaminophen, duloxetine and tramadol are only CONDITIONAL recommendations.

    Kolasinski SL, Neogi T, Hochberg MC, et al. — 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee.. Arthritis & Rheumatology, 2020. DOI: 10.1002/art.41142.

  3. In the only randomised controlled trial to compare total knee replacement directly with non-surgical treatment in patients already eligible for surgery (n=100), the replacement group improved more at 12 months than the non-surgical group (KOOS4 32.5 vs 16.0; adjusted mean difference 15.8, 95% CI 10.0 to 21.5) but had four times the serious adverse events (24 vs 6, P=0.005). Only 13 of 50 patients (26%) assigned to non-surgical treatment alone had undergone knee replacement by 12 months.

    Skou ST, Roos EM, Laursen MB, et al. — A Randomized, Controlled Trial of Total Knee Replacement.. New England Journal of Medicine, 2015. DOI: 10.1056/NEJMoa1505467.

  4. The RESTORE trial randomised 288 community-based participants aged 50+ with symptomatic medial knee OA (Kellgren-Lawrence grade 2 or 3) to three weekly intra-articular injections of leukocyte-poor PRP or saline placebo, with participants, injectors and assessors all blinded. 93% completed the 12-month follow-up. PRP did not produce a clinically meaningful improvement in knee pain over placebo, and did not slow medial tibial cartilage volume loss on MRI.

    Bennell KL, Paterson KL, Metcalf BR, et al. — Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial.. JAMA, 2021. DOI: 10.1001/jama.2021.19415.

  5. A systematic review and meta-analysis of 169 randomised trials (21,163 participants) of viscosupplementation for knee OA found clear evidence of small-study effects and publication bias. The prespecified main analysis, restricted to 24 large placebo-controlled trials with at least 100 participants per group (8,997 randomised), found a pain reduction of SMD -0.08 (95% CI -0.15 to -0.02) - the confidence interval excluding the prespecified minimal clinically important difference of -0.37.

    Pereira TV, Jüni P, Saadat P, et al. — Viscosupplementation for knee osteoarthritis: systematic review and meta-analysis.. BMJ, 2022. DOI: 10.1136/bmj-2022-069722.

  6. A meta-analysis of nine randomised trials of arthroscopic surgery for degenerative knee disease in middle-aged and older patients found a small pain benefit (effect size 0.14, 95% CI 0.03 to 0.26), equal to 2.4mm on a 0-100mm visual analogue scale, present at 3 and 6 months but gone by 24 months, and no significant benefit for physical function (effect size 0.09, 95% CI -0.05 to 0.24). Documented harms included symptomatic deep venous thrombosis (4.13 events per 1,000 procedures, 95% CI 1.78 to 9.60), pulmonary embolism, infection and death.

    Thorlund JB, Juhl CB, Roos EM, et al. — Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms.. BMJ, 2015. DOI: 10.1136/bmj.h2747.

A knee exam can clarify the next choice

QC Kinetix provides regenerative treatment options, including PRP; medical providers spin a sample of your blood and place its prepared portion in the knee. They can examine the joint, hear what limits you and discuss whether that procedure fits. No result is promised, and there is no charge for the consultation.

For most Mesa residents, the Chandler location is on South Dobson Road. Call (602) 837-PAIN or use the booking link to arrange the visit. Have your current medicines and a brief symptom history ready.

Book a free consultation