Is it safe to keep exercising with knee arthritis?

Yes, for most people exercise is one of the most helpful treatments for knee arthritis. Strength training and low-impact cardio can reduce pain and improve function over time. Some soreness during or after exercise is common, and we help you adjust the load so the knee settles by the next day.

Can PRP grow back cartilage in an arthritic knee?

No. PRP and other orthobiologic injections do not rebuild cartilage in the knee. They may reduce pain and improve how the knee works, which can make it easier to stay active and keep up with strength training.

What is the difference between joint denervation and a knee replacement?

Joint denervation treats the small sensory nerves that carry pain signals from the knee, so it targets pain without changing the joint itself. A knee replacement removes the damaged joint surfaces and replaces them with an implant. Denervation is an option for people who are not ready for, or not good candidates for, replacement surgery.

When should knee arthritis be seen by a surgeon?

Surgery is worth discussing when pain limits daily life despite a good trial of conservative care, or when the knee is badly deformed or unstable. We talk through this openly and help coordinate a referral when replacement is the right step.

Knee Arthritis: Non-Surgical Orthopedic Treatment in Bethesda, MD

About knee arthritis

Knee arthritis, also called knee osteoarthritis, happens when the smooth cartilage that lines the ends of the thigh bone, shin bone, and kneecap gradually thins. The joint lining can become irritated, bone spurs may form, and the knee can swell, stiffen, and ache. It is one of the most common reasons adults cut back on walking, running, and the activities they enjoy.

Arthritis is not simply wear and tear that only gets worse. Pain often comes and goes in flares, and many people with changes on an X-ray have little pain, while others hurt a great deal. What happens in the muscles around the knee, your overall activity level, sleep, and body weight all shape how the knee feels day to day.

Our goal is to keep you moving. Staying active is one of the best things you can do for an arthritic knee, and we build a plan that lets you keep exercising rather than handing you a list of things to avoid.

Knee X-rays showing the Kellgren and Lawrence grades of osteoarthritis, from grade 0 to grade 4. — Knee arthritis is graded on X-ray from 0 (normal) to 4 (severe), based on joint space narrowing and bone spurs.

Common symptoms

Aching pain in or around the knee that worsens with standing, walking, or stairs
Morning stiffness or stiffness after sitting that loosens up within about half an hour
Swelling or a feeling of fullness in the knee after activity
Grinding, clicking, or a crunching sensation with movement
Reduced ability to fully bend or straighten the knee
Occasional episodes of the knee feeling weak or unreliable

Common causes and risk factors

Age-related changes in the joint, often combined with family history
An old knee injury, such as a meniscus tear or ligament injury
Extra body weight, which increases the load on the knee with every step
Weakness in the thigh and hip muscles that support the knee
Alignment differences, such as bowed legs or knock knees

How we diagnose it

Our physicians start with a detailed conversation and a hands-on exam of the knee, hip, and how you move. We use diagnostic ultrasound at the exam table to look for fluid, an irritated joint lining, a Baker's cyst, or tendon problems that can mimic or add to arthritis pain. Standing X-rays show how much joint space remains and help guide which options make sense for you.

How Propel treats knee arthritis

Conservative care comes first. We build a progressive strength program for the thigh, hip, and calf muscles, adjust training load rather than stopping activity, and look at sleep, nutrition, and weight, since each one affects joint pain. When a flare needs calming, an ultrasound-guided injection places medicine precisely inside the joint, and our physicians perform every procedure themselves.

For ongoing pain, Dr. Gruner and Dr. Chen offer orthobiologic injections: PRP, BMAC (a concentrate from your own bone marrow), and microfragmented adipose tissue (MFAT; your own fat tissue, gently processed). These do not rebuild cartilage, but they may ease pain and improve function. For people delaying or avoiding knee replacement, Dr. Chen performs joint denervation and peripheral nerve stimulation, and when replacement is the better choice, we help coordinate a surgical referral.

All knee procedures

Watch: Knee Arthritis explained

Who is likely to benefit from a PRP knee injection, what the visit involves, and when another option makes more sense.Featuring Dr. Gruner

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.

Rehab protocols

Dr. Gruner's week-by-week recovery guidelines. Your plan is individualized; follow these with your physician and physical therapist.

Knee & Hip Joint — Ultrasound-Guided PRP / Adipose / BMAC Injection ProtocolView PDF

Clinical evidence

Published studies our physicians draw on. Results in studies do not predict any one person's outcome.

Questions about knee arthritis

Is it safe to keep exercising with knee arthritis?: Yes, for most people exercise is one of the most helpful treatments for knee arthritis. Strength training and low-impact cardio can reduce pain and improve function over time. Some soreness during or after exercise is common, and we help you adjust the load so the knee settles by the next day.
Can PRP grow back cartilage in an arthritic knee?: No. PRP and other orthobiologic injections do not rebuild cartilage in the knee. They may reduce pain and improve how the knee works, which can make it easier to stay active and keep up with strength training.
What is the difference between joint denervation and a knee replacement?: Joint denervation treats the small sensory nerves that carry pain signals from the knee, so it targets pain without changing the joint itself. A knee replacement removes the damaged joint surfaces and replaces them with an implant. Denervation is an option for people who are not ready for, or not good candidates for, replacement surgery.
When should knee arthritis be seen by a surgeon?: Surgery is worth discussing when pain limits daily life despite a good trial of conservative care, or when the knee is badly deformed or unstable. We talk through this openly and help coordinate a referral when replacement is the right step.

What can I do about knee arthritis pain without surgery?