--- title: "Knee Arthritis" --- ## More Options Than Cortisone or Surgery Knee arthritis is one of those diagnoses where most patients have been told there are essentially two paths: cortisone shots until you cannot get any more, then knee replacement when you cannot take it anymore. That is a frustrating roadmap, particularly if you hike, play tennis, golf, dance, run, or just want to move freely without your knee dictating the terms. The reality is that knee arthritis has more treatment options than any other joint arthritis. Hyaluronic acid injections FDA-approved specifically for the knee. Multiple regenerative approaches with robust evidence. Nerve-targeted procedures that can provide pain relief lasting up to two years from a single treatment. Combinations that work better than any single approach alone. The right path depends on your stage of arthritis, what you have already tried, and what you actually want to do with your knee. Most patients have more options than they have been told. ## What Knee Arthritis Actually Is Your knee is a hinge joint where the femur, tibia, and patella meet, with cartilage covering the ends of the bones and the meniscus providing additional cushioning. Knee arthritis develops when this cartilage wears down. The most common form is osteoarthritis, related to age, wear, prior injury, or genetics. Inflammatory arthritis affects the knee differently and is coordinated with rheumatology, and post-traumatic arthritis develops years after a significant injury. As cartilage wears, bone-on-bone contact develops gradually, inflammation increases, bone spurs form, and the joint's natural lubricating fluid often becomes less effective. The result is the symptoms most patients experience: pain, stiffness, swelling, limited motion, and difficulty with specific activities. ## What Stage Is Your Knee Arthritis? Knee arthritis exists on a spectrum, and treatment recommendations vary significantly by stage. Early-stage arthritis involves intermittent pain mostly with activity and imaging showing some cartilage thinning but joint space largely preserved; regenerative medicine is often particularly worth exploring at this stage. Moderate arthritis involves more consistent pain, more noticeable stiffness, occasional swelling, and moderate joint space narrowing, with hyaluronic acid often becoming relevant alongside regenerative options. Advanced arthritis involves significant daily pain, substantial movement limitation, frequent swelling, and severe narrowing or bone-on-bone contact; non-surgical options including genicular nerve procedures are still possible, but knee replacement often becomes appropriate for patients seeking to recover their function. Many patients are surprised by the range of options that fit their specific stage. ## How PHI Treats Knee Arthritis Treatment begins with a comprehensive evaluation of your symptoms, activity goals, alignment, imaging, and where you fall on the arthritis spectrum. Based on that, options at PHI include: Image-guided knee injections with cortisone for fast relief from inflammation, with the cumulative effects of repeated cortisone discussed honestly. Hyaluronic acid (Orthovisc), FDA-approved specifically for knee osteoarthritis, which replenishes the joint's natural lubricating fluid with relief that develops gradually but typically lasts longer than cortisone. PRP therapy, which has a strong evidence base for knee osteoarthritis with significant pain relief and functional improvement at 6 and 12 months. A2M therapy, which neutralizes cartilage-destroying enzymes and is particularly relevant for early-to-moderate arthritis. Stem cell therapy for moderate to severe arthritis or after PRP. Exosome therapy within comprehensive protocols. Genicular nerve blocks, which both diagnose and provide therapeutic relief by targeting the nerves carrying pain signals from the knee. And genicular radiofrequency ablation, which ablates those nerves and can provide durable pain relief from a single procedure, particularly valuable for patients trying to delay or avoid knee replacement, those who are not surgical candidates, or those with persistent pain after knee replacement. When knee replacement is the right next step, we coordinate with orthopedic specialists. ## When to See Someone Consider professional evaluation when your knee pain has lasted more than four to six weeks without improvement, when it interferes with activities you want to do, when you are avoiding exercise because of it, when you want to understand non-surgical options, when you want to delay or avoid knee replacement, or when conservative treatments have not provided adequate relief. Seek prompt evaluation if you experience sudden severe knee pain following an injury, inability to bear weight on the leg, significant knee swelling, warmth, or redness, or knee pain accompanied by fever or feeling unwell. ## Why PHI for Knee Arthritis ## Frequently Asked Questions **Q: How do I know which treatment is right for me?** This depends on your stage of arthritis, treatment history, goals, and imaging. Cortisone is fast but cumulative. Hyaluronic acid is FDA-approved for the knee and lasts longer but takes longer to develop. PRP and other regenerative options work over a longer horizon and address tissue rather than only inflammation. Genicular ablation provides durable relief by targeting nerves. Each fits different situations, and we help you understand which fits yours. **Q: How effective is genicular ablation for knee arthritis?** Genicular nerve ablation has strong recent evidence, with trials showing durable relief for a majority of appropriately selected patients. This durability is unusual among non-surgical interventions for knee arthritis and makes it particularly valuable for patients trying to delay knee replacement. **Q: Will I need knee replacement?** This depends on the stage of your arthritis and how it is affecting your life. Many patients with mild to moderate arthritis can delay or avoid replacement through injections, regenerative treatments, genicular ablation, and lifestyle modifications. Patients with severe end-stage arthritis often eventually benefit from replacement, and we are honest about which category fits you. **Q: Are repeated cortisone injections safe for the knee?** Cortisone is well-established and effective. Some studies have raised concerns about potential cartilage effects with frequent repeated injections in the same joint. For most patients occasional cortisone is appropriate. For patients needing frequent repeat injections, longer-lasting options like hyaluronic acid, genicular ablation, or regenerative protocols often make more sense. **Q: How is hyaluronic acid different from cortisone?** Cortisone reduces inflammation and provides faster relief lasting weeks to a few months, with cumulative effects from repeat injections. Hyaluronic acid replenishes the joint's natural lubricating fluid and works through a different mechanism, with relief that develops more gradually but typically lasts longer. Hyaluronic acid is FDA-approved specifically for knee osteoarthritis. **Q: Can regenerative treatments rebuild cartilage?** Rebuild is rarely the right word. Regenerative treatments do not typically grow back lost cartilage. They can support remaining cartilage, reduce inflammation, slow further loss, and address pain through tissue-level mechanisms. For appropriate patients this can produce meaningful, lasting improvement, particularly combined with appropriate exercise. **Q: Should I try multiple treatments at once or one at a time?** This depends on your situation. For most patients we recommend trying one approach at a time so we can evaluate response. For some, combining approaches such as genicular ablation plus regenerative therapy makes sense. We discuss combination strategies during consultation. **Q: Can I exercise with knee arthritis?** Yes, with appropriate adjustments. Continued movement is one of the most important factors for management. Heavy-impact activities may need modification, while low-impact activities like cycling, swimming, walking, and the elliptical are typically beneficial. **Q: Are these treatments covered by insurance?** Insurance coverage and payment options may vary. We provide documentation for you to seek reimbursement through your out-of-network benefits, which may apply to certain services. All pricing is disclosed at consultation. **Q: Do you accept international patients?** Yes. PHI regularly treats patients from outside Los Angeles, including Las Vegas, Palm Springs, London, and other international locations. ## Treatments We Offer for Knee Arthritis PHI offers the full range of evidence-based treatments for knee arthritis. Your physician will recommend the right option, or combination, based on the stage of your arthritis, your imaging, your goals, and your treatment history. - Knee Injections, image-guided cortisone and hyaluronic acid (Orthovisc) - PRP Therapy - Stem Cell Therapy - A2M Therapy - Exosome Therapy - Genicular Nerve Block, diagnoses and treats knee pain by targeting the genicular nerves - Genicular Radiofrequency Ablation, durable relief from a single procedure > The effectiveness of alpha-2-macroglobulin injections for osteoarthritis of the knee: a randomized controlled trial. Peer-reviewed via PubMed, 2024. — [Thompson K, et al.](https://pubmed.ncbi.nlm.nih.gov/39259950/) > Intra-articular hyaluronic acid for knee osteoarthritis: a systematic umbrella review. Peer-reviewed via PMC, 2025. — [Glinkowski WM, et al.](https://pmc.ncbi.nlm.nih.gov/articles/PMC11856182/) > Clinical practice guideline: management of osteoarthritis of the knee. American Academy of Orthopaedic Surgeons. — [American Academy of Orthopaedic Surgeons](https://www.aaos.org/quality/quality-programs/lower-extremity-programs/osteoarthritis-of-the-knee/) ## Schedule Your Knee Arthritis Consultation A 60-minute consultation will identify what stage of knee arthritis you are dealing with, walk through the treatment options that match it, and give you a clear plan. Call (310) 856-9488 or book online now. ```ld+json { "@context": "https://schema.org", "@graph": [ { "@context": "https://schema.org", "@type": "MedicalCondition", "@id": "https://painandhealing.com/concerns/knee-arthritis/#concern", "name": "Knee Arthritis", "url": "https://painandhealing.com/concerns/knee-arthritis/", "description": "Most patients are handed a two-step roadmap: cortisone until it stops working, then replacement. 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This depends on your stage of arthritis, treatment history, goals, and imaging. Cortisone is fast but cumulative. Hyaluronic acid is FDA-approved for the knee and lasts longer but takes longer to develop. PRP and other regenerative options work over a longer horizon and address tissue rather than only inflammation. Genicular ablation provides durable relief by targeting nerves. Each fits different situations, and we help you understand which fits yours.

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Genicular nerve ablation has strong recent evidence, with trials showing durable relief for a majority of appropriately selected patients. This durability is unusual among non-surgical interventions for knee arthritis and makes it particularly valuable for patients trying to delay knee replacement.

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This depends on the stage of your arthritis and how it is affecting your life. Many patients with mild to moderate arthritis can delay or avoid replacement through injections, regenerative treatments, genicular ablation, and lifestyle modifications. Patients with severe end-stage arthritis often eventually benefit from replacement, and we are honest about which category fits you.

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Cortisone is well-established and effective. Some studies have raised concerns about potential cartilage effects with frequent repeated injections in the same joint. For most patients occasional cortisone is appropriate. For patients needing frequent repeat injections, longer-lasting options like hyaluronic acid, genicular ablation, or regenerative protocols often make more sense.

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Cortisone reduces inflammation and provides faster relief lasting weeks to a few months, with cumulative effects from repeat injections. Hyaluronic acid replenishes the joint's natural lubricating fluid and works through a different mechanism, with relief that develops more gradually but typically lasts longer. Hyaluronic acid is FDA-approved specifically for knee osteoarthritis.

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Rebuild is rarely the right word. Regenerative treatments do not typically grow back lost cartilage. They can support remaining cartilage, reduce inflammation, slow further loss, and address pain through tissue-level mechanisms. For appropriate patients this can produce meaningful, lasting improvement, particularly combined with appropriate exercise.

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This depends on your situation. For most patients we recommend trying one approach at a time so we can evaluate response. For some, combining approaches such as genicular ablation plus regenerative therapy makes sense. We discuss combination strategies during consultation.

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Yes, with appropriate adjustments. Continued movement is one of the most important factors for management. Heavy-impact activities may need modification, while low-impact activities like cycling, swimming, walking, and the elliptical are typically beneficial.

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Insurance coverage and payment options may vary. We provide documentation for you to seek reimbursement through your out-of-network benefits, which may apply to certain services. All pricing is disclosed at consultation.

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Yes. PHI regularly treats patients from outside Los Angeles, including Las Vegas, Palm Springs, London, and other international locations.

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