# What to know about common knee questions *FAQ | Non-Surgical Knee Treatment Tempe* > Non-surgical knee treatment Tempe questions about bone-on-bone knees, walking, surgery timing, cost, and daily care. A knee question often comes up after a rough morning or a bad set of stairs. You want a straight answer before you spend more time or money. These answers cover the usual concerns, but they can’t replace an exam. Start with the question that sounds most like your day. ## Sources 1. The Lancet's osteoarthritis Seminar states that the diagnosis of osteoarthritis is clinically based despite the widespread OVERUSE of imaging methods, that management should be tailored to the individual and focus on core treatments including self-management and education, exercise and weight loss as relevant, and that surgery should be reserved for those who have not responded appropriately to less invasive methods. Hunter DJ, Bierma-Zeinstra S. — [Osteoarthritis.](https://pubmed.ncbi.nlm.nih.gov/31034380/). *The Lancet*, 2019. DOI: 10.1016/S0140-6736(19)30417-9. 2. 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.](https://pubmed.ncbi.nlm.nih.gov/26488691/). *New England Journal of Medicine*, 2015. DOI: 10.1056/NEJMoa1505467. 3. A systematic review of prospective studies in unselected osteoarthritis patients found that the proportion reporting an unfavourable long-term pain outcome ranged from about 7% to 23% after hip replacement and 10% to 34% after knee replacement; in the best-quality studies, 9% or more after hip and about 20% after knee replacement. Beswick AD, Wylde V, Gooberman-Hill R, et al. — [What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients.](https://pubmed.ncbi.nlm.nih.gov/22357571/). *BMJ Open*, 2012. DOI: 10.1136/bmjopen-2011-000435. 4. Pooled national registry data covering 299,291 total knee replacements across 14 registries give a 25-year all-cause survival of 82.3% (95% CI 81.3-83.2); pooled 25-year survival of unicompartmental knee replacements across four registries was 69.8% (67.6-72.1). Evans JT, Walker RW, Evans JP, et al. — [How long does a knee replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up.](https://pubmed.ncbi.nlm.nih.gov/30782341/). *The Lancet*, 2019. DOI: 10.1016/S0140-6736(18)32531-5. 5. 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.](https://pubmed.ncbi.nlm.nih.gov/31278997/). *Osteoarthritis and Cartilage*, 2019. DOI: 10.1016/j.joca.2019.06.011. 6. 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.](https://pubmed.ncbi.nlm.nih.gov/31908163/). *Arthritis & Rheumatology*, 2020. DOI: 10.1002/art.41142. 7. The RESTORE trial randomized 288 adults aged 50+ with symptomatic mild-to-moderate medial knee OA to three weekly leukocyte-poor PRP injections or saline placebo. At 12 months, pain change was -2.1 vs -1.8 points (difference -0.4; 95% CI -0.9 to 0.2; P=.17) and medial tibial cartilage volume change was -1.4% vs -1.2% (P=.81). 29 of 31 prespecified secondary outcomes showed no significant between-group difference. The authors concluded the findings 'do not support use of PRP for the management of knee OA.' 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.](https://pubmed.ncbi.nlm.nih.gov/34812863/). *JAMA*, 2021. DOI: 10.1001/jama.2021.19415. 8. A BMJ meta-analysis of 169 trials (21,163 participants) found viscosupplementation (hyaluronic acid injection) reduced knee OA pain by SMD -0.08 (95% CI -0.15 to -0.02) in the 24 large placebo-controlled trials — about 2.0 mm on a 100 mm scale, far below the prespecified 0.37 SMD minimal clinically important difference — and increased serious adverse events (RR 1.49, 95% CI 1.12 to 1.98). Trial sequential analysis showed conclusive evidence of clinical equivalence to placebo has existed since 2009. Pereira TV, Juni P, Saadat P, et al. — [Viscosupplementation for knee osteoarthritis: systematic review and meta-analysis.](https://pubmed.ncbi.nlm.nih.gov/36333100/). *BMJ*, 2022. DOI: 10.1136/bmj-2022-069722. 9. FDA states verbatim: 'None of these products have been approved for the treatment of any orthopedic condition, such as osteoarthritis, tendonitis, disc disease, tennis elbow, back pain, hip pain, knee pain, neck pain, or shoulder pain.' The only FDA-approved stem cell products in the United States are blood-forming (hematopoietic progenitor) cells derived from umbilical cord blood, approved only for disorders of blood production. There are currently NO FDA-approved exosome products. U.S. Food and Drug Administration — [Consumer Alert on Regenerative Medicine Products Including Stem Cells and Exosomes](https://www.fda.gov/vaccines-blood-biologics/consumers-biologics/consumer-alert-regenerative-medicine-products-including-stem-cells-and-exosomes). *FDA (Center for Biologics Evaluation and Research)*, 2020. ## Can you live with bone-on-bone knees without surgery? Yes, in some cases, because an X-ray and daily soreness don’t always match. Sleep, walking, swelling, the knee’s shape, and changes in daily use all matter. If those problems keep getting worse after exercise, medicine, and other non-surgical care, ask whether surgery now offers more than waiting. ## Does an X-ray showing bone on bone mean I need surgery? No. The image matters, but it doesn’t decide surgery by itself. Your doctor also needs to hear about rest soreness, sleep, walking, stairs, lost motion, and prior care. Severe wear with manageable days differs from wear paired with steady decline. ## Is knee arthritis just part of getting older? Age raises the chance of arthritis, but it doesn’t mean nothing can help. Past injury, weight, muscle strength, and years of work or sports can matter too. Exercise, shorter level walks, medicine, a brace, a steroid shot, or PRP made from your own blood may ease soreness. They don’t make the joint young again. ## What can be done for a knee that is bone-on-bone? Start with what the knee still lets you do. Strength work, shorter walks, a walking aid, a brace, or medicine may help. If you’re losing sleep, motion, or basic daily use despite trying those things, discuss surgery along with non-surgical choices. ## Is walking actually good for bone-on-bone knee pain? Walking can help when the amount suits the knee. Choose level ground, stop before your stride changes, and check how the knee feels by morning. If each walk brings a larger flare, shorten the distance and get the knee examined before going farther. ## How long does a knee replacement last? Records from many operations estimate that about 82% of total knee replacements had not needed a second operation at twenty-five years. That doesn’t mean everyone had no soreness or trouble. Ask how your age, health, activity, and operation affect the estimate. ## How much do knee procedures cost in Arizona? The sources here don’t give a reliable Arizona average. Price depends on the procedure, how its material is made, how many visits are included, whether an image is used during it, and which parts your insurance doesn’t pay for. Ask for the full charge in writing before agreeing. A higher price doesn’t prove that a treatment works better. ## Before I agree to joint replacement, which questions should I raise? Ask why surgery makes sense now, what relief is realistic, and what help you may need at home. Ask about serious risks, how long the implant may last, and what more delay could mean for sleep and walking. Take notes so memory doesn’t have to carry the whole visit. ## What to bring when you’re ready to talk Bring your X-ray if you have it, a medicine list, and notes on sleep, swelling, walking, and stairs. Ask how the exam works, what the full cost includes, and when any benefit would be judged. For central and south Tempe, Chandler is usually the direct route. Scottsdale may be shorter from north Tempe. Call (602) 837-PAIN or choose the easier office through the booking link. Book a free consultation: --- Clear help for a knee that keeps bothering you. A plain Tempe guide to knee replacement alternatives, bone-on-bone soreness, things to try, surgery timing, and nearby help. Plain guidance for Tempe knee soreness, daily care, treatment choices, and surgery questions. This site is operated by the owners of the QC Kinetix Phoenix-area clinics, including the Chandler and Scottsdale locations described here; the owners benefit when readers book with those clinics. Copyright 2026 Tempe Knee Liner Notes. General education about knee-care decisions, not medical advice for an individual knee.