Written by Dr. YT Chen
Propel Sports and Orthobiologics
What knee arthritis is, and what treatment can change
Knee osteoarthritis is gradual wear of the smooth cartilage that lines the joint, along with changes in the bone, the lining of the joint, and the muscles around it. Pain does not track neatly with X-ray findings. Some people with severe-looking images feel fine, while others with mild changes hurt every day.
That gap is good news. Much of arthritis pain comes from factors that can be improved: weak thigh and hip muscles, extra body weight, joint irritation, and sensitized nerves. No current treatment, including orthobiologic injections, can rebuild lost cartilage, so the realistic goal is less pain, better function, and more time with your own knee.
Strength training is the foundation
Strong quadriceps, hamstrings, and hip muscles absorb force that would otherwise pass through the joint. A progressive program, where the load increases over weeks, is one of the most effective treatments for knee arthritis, and it helps no matter what else you try.
Movement is medicine here, not a risk. Cycling, swimming, walking, and supervised lifting are generally safe for arthritic knees. The aim is to keep you active by adjusting how you train, not to hand you a list of things to avoid. Good sleep and steady daily activity also help lower pain sensitivity.
Weight and whole-body health
Each step places a load on the knee that is several times your body weight, so even modest weight loss meaningfully reduces joint stress. Weight change can also lower the body-wide inflammation that makes arthritis pain worse.
We look at the whole picture, including nutrition, other health conditions, and medications, and we coordinate with your primary care physician when weight management support would help.
Injections: what each one can and cannot do
Several injections can calm a painful knee, and at Propel each one is placed under ultrasound guidance. A cortisone injection can settle a flare with swelling, though relief is often temporary and repeat doses are limited. Hyaluronic acid, sometimes called gel injections, is another option for some patients.
Platelet-rich plasma (PRP) has growing evidence for mild to moderate knee arthritis and may ease pain and improve function for longer than cortisone in some people. Bone marrow concentrate and microfragmented fat, both taken from your own body, are also used in select cases. To be clear: these orthobiologics do not regrow or rebuild cartilage. They may help the joint feel and work better.
Genicular nerve treatments for persistent pain
The genicular nerves are small sensory nerves that carry pain signals from the knee joint. Dr. Chen uses joint denervation, including ultrasound-guided radiofrequency ablation, to quiet these nerves with controlled heat. A test block with numbing medicine usually comes first to confirm the nerves are the right target.
This approach can suit people with moderate to severe arthritis who are not ready for surgery, prefer to delay it, or are not good surgical candidates. It does not change the joint itself, and because nerves slowly recover, pain can return and the procedure can often be repeated. For some patients, peripheral nerve stimulation is another nerve-focused option.
When knee replacement is the right answer
Knee replacement is an excellent operation for the right person. It is worth serious consideration when arthritis is advanced, pain wakes you at night or limits walking and daily tasks despite a full course of conservative care, or the knee is visibly bowing or giving way. We help coordinate referral to an orthopedic surgeon when that time comes.
A knee that becomes suddenly hot, red, and swollen, especially with fever, needs same-day medical care to rule out infection. Knee pain can also come from the kneecap joint or even the hip, so an accurate diagnosis at the start shapes every step that follows.
Frequently asked questions
- Can PRP help an arthritic knee if the cartilage is worn?
- PRP does not rebuild or regrow worn cartilage. It may reduce pain and improve function in mild to moderate knee arthritis, and it works best alongside a strength program.
- Is it safe to exercise with knee arthritis?
- Yes. Exercise, especially strength training, is one of the most helpful treatments for knee arthritis. Some soreness during or after exercise is common and usually acceptable if it settles by the next day. Your physician or therapist can adjust the plan if a certain movement keeps flaring the knee.
- Who is a candidate for genicular nerve radiofrequency ablation?
- Genicular nerve ablation is typically considered for people with ongoing knee arthritis pain who have tried exercise and other conservative care. It can also help people waiting for surgery, wishing to delay it, or unable to have it. A diagnostic nerve block is usually done first to see whether the treatment is likely to help.
- Will injections now make a future knee replacement harder?
- Most injections do not prevent a later knee replacement, but surgeons often ask for a gap of a few months between a cortisone injection and surgery to lower infection risk. We keep a record of your injections and share it with your surgeon if you decide to go ahead.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.