Not every arthritic joint needs surgery. For early to moderate stages, real options exist — and they actually work.
Dr. Malhotra is a joint replacement surgeon. His first question in clinic is still whether surgery is actually necessary right now. Many patients who come expecting a surgical recommendation leave with an injection, a physiotherapy programme, and a follow-up plan. That is not a compromise — it is correct management.
The muscles around the knee — quadriceps, hamstrings, hip abductors — reduce joint load when they are strong. A knee with weak quads carries 30–40% more load on the joint surface with every step. A targeted physiotherapy programme designed for arthritic knees, not generic gym exercises, can meaningfully reduce pain and delay the need for surgery by years.
ARV Hospital works with experienced physiotherapists who understand post-arthritic rehabilitation. We provide specific programmes and monitor progress at follow-up.
Intra-articular corticosteroid (steroid) injections reduce inflammation inside the joint. They are effective for most patients with moderate arthritis — providing 3–6 months of meaningful pain relief. They do not reverse arthritis or repair cartilage, but they can make physiotherapy possible and allow patients to function through a difficult period.
We use fluoroscopy or ultrasound guidance for accuracy. Frequency is limited to 3–4 times per year to avoid cartilage side effects.
Hyaluronic acid (HA) is the natural lubricant of joint fluid. Viscosupplementation injections (Synvisc, Durolane, Hyalgan) restore lubrication in arthritic joints. Best evidence is in early-to-moderate osteoarthritis. Effects last 6–12 months in responsive patients. A course of 1–3 injections is given over several weeks.
PRP uses growth factors from your own blood to reduce joint inflammation and potentially slow cartilage degradation. Blood is drawn, centrifuged, and the concentrated platelet layer is injected into the joint. Evidence is strongest for early osteoarthritis and cartilage lesions. PRP is not a cure, but it can meaningfully reduce pain and improve function for 12–18 months in appropriate patients.
The mechanics are straightforward: every 1kg of body weight lost reduces the force through the knee joint by 4kg per step. For a patient 10kg overweight, that is 40kg less load on a joint that is already damaged. Weight management combined with physiotherapy is the most effective non-surgical intervention for knee arthritis. We provide practical guidance, not lectures.
For patients with predominantly medial compartment (inner knee) arthritis, an unloader brace shifts load to the lateral compartment, which is less damaged. This can provide significant pain relief and delay surgery. Braces are most effective in patients with unicompartmental arthritis and good ligament stability.