Chicago Knee Arthritis Treatment: Surgery vs. Non-Surgical Options

For Chicago residents living with knee arthritis, one of the biggest decisions is whether to pursue surgery or try non-surgical treatments first. This guide compares both approaches so you can have an informed conversation with your doctor about what is right for you.

Key Takeaways

Most orthopedic guidelines recommend trying non-surgical treatments before considering knee replacement
Non-surgical options can provide years of relief for many patients with mild to moderate arthritis
Knee replacement surgery has excellent outcomes but requires significant recovery time
Your age, arthritis severity, activity goals, and overall health all factor into the decision
Chicago has world-class options for both surgical and non-surgical knee care

Understanding Knee Arthritis Severity

The right treatment depends heavily on how advanced your arthritis is. Doctors typically use the Kellgren-Lawrence (KL) grading system:

Grade 1 (Minimal): Possible narrowing of joint space, minor bone spurs Grade 2 (Mild): Definite bone spurs, possible joint space narrowing Grade 3 (Moderate): Moderate joint space narrowing, multiple bone spurs, some bone deformity Grade 4 (Severe): Significant joint space narrowing, large bone spurs, severe bone deformity (“bone-on-bone”)

General treatment guidance:

Grades 1-2: Typically start with conservative treatments
Grade 3: May respond to injections and physical therapy, but surgery may be discussed
Grade 4: Often requires surgical consideration, though some patients still respond to non-surgical care

Non-Surgical Treatment Options in Chicago

Chicago’s medical community offers a full range of non-surgical knee arthritis treatments.

Physical Therapy

Physical therapy is the foundation of non-surgical arthritis care. Chicago has numerous PT clinics specializing in joint conditions.

What it involves:

Strengthening exercises for muscles around the knee
Flexibility and range of motion work
Manual therapy techniques
Education on joint protection

Effectiveness: Research shows physical therapy can reduce pain and improve function comparably to surgery for some patients with moderate arthritis.

Timeline: Typically 2-3 sessions weekly for 6-8 weeks, with ongoing home exercises.

Injection Therapies

Cortisone injections provide quick inflammation relief:

Onset: 2-7 days
Duration: 4-8 weeks typically
Best for: Acute flare-ups, inflammation
Limitations: Effects decrease with repeated use; potential cartilage concerns with overuse

Hyaluronic acid injections (gel shots) restore joint lubrication:

Onset: 2-4 weeks for full effect
Duration: 6 months or longer
Best for: Mild to moderate arthritis
Coverage: Medicare and most insurance

PRP injections use your blood platelets to promote healing:

Onset: Variable, may take months
Duration: Research ongoing
Best for: Patients seeking regenerative options
Coverage: Usually not covered by insurance

Medications

Oral medications:

Acetaminophen for pain
NSAIDs (ibuprofen, naproxen) for pain and inflammation
Prescription options for more severe pain

Topical treatments:

Diclofenac gel (Voltaren)
Capsaicin cream
Lidocaine patches

Lifestyle Modifications

Weight management: Every pound of body weight equals about 4 pounds of stress on your knees. Losing even 10-15 pounds can significantly reduce pain.

Low-impact exercise: Swimming, cycling, and walking help maintain joint function without excessive stress.

Bracing: Unloader braces can shift weight away from the damaged part of your knee.

Surgical Treatment Options in Chicago

When non-surgical treatments no longer provide adequate relief, surgery becomes an option. Chicago is home to some of the nation’s top orthopedic surgeons and medical centers.

Arthroscopic Surgery

What it is: Minimally invasive surgery using small incisions and a camera to clean out the joint, remove loose cartilage, or repair minor damage.

Best for: Mechanical symptoms like locking or catching, loose bodies in the joint.

Recovery: 2-6 weeks typically.

Important note: Research shows arthroscopy has limited benefit for pure osteoarthritis without mechanical symptoms. It is not a replacement for knee replacement.

Partial Knee Replacement (Unicompartmental)

What it is: Replacing only the damaged portion of the knee while preserving healthy bone and ligaments.

Best for: Arthritis limited to one compartment of the knee, active patients with good range of motion.

Recovery: Faster than total replacement, typically 4-6 weeks to return to most activities.

Outcomes: Excellent pain relief with more natural knee feel. About 90% survive 10+ years.

Total Knee Replacement

What it is: Replacing all surfaces of the knee joint with metal and plastic components.

Best for: Severe arthritis affecting multiple knee compartments, significant pain and disability despite other treatments.

Recovery:

Hospital: 1-3 days (some same-day procedures now available)
Walking with assistance: Immediately
Return to driving: 4-6 weeks
Return to most activities: 3 months
Full recovery: 6-12 months

Outcomes: Over 90% of patients report significant pain relief. About 95% of replacements last 15+ years.

Comparing Surgery vs. Non-Surgical: Key Factors

Factor	Non-Surgical	Surgery
Recovery time	Minimal	Weeks to months
Pain relief duration	Months (may need repeat treatment)	Long-term (15+ years)
Activity restrictions	Few	Temporary, then few
Risks	Low	Higher (blood clots, infection, complications)
Cost	Lower per treatment, but ongoing	Higher upfront, but one-time
Best for	Mild-moderate arthritis	Severe arthritis, failed conservative care

Who Should Consider Non-Surgical Options First?

Non-surgical treatments are typically recommended as the first approach for:

Patients with mild to moderate arthritis: Earlier-stage arthritis often responds well to physical therapy, injections, and lifestyle changes.

Younger patients: Research shows knee replacements in patients under 55 have higher revision rates. Delaying surgery when possible is often beneficial.

Those who want to avoid surgery: Some patients simply prefer to try all other options first.

Patients with health conditions increasing surgical risk: Heart disease, diabetes, obesity, and other conditions increase surgical complications.

Active patients with specific goals: Injections and physical therapy may keep you doing activities you love without the recovery time surgery requires.

Who Is a Candidate for Knee Replacement?

Knee replacement may be the right choice for:

Patients with severe arthritis: When you truly have bone-on-bone arthritis with significant pain and disability.

Those who have exhausted conservative options: If physical therapy, injections, and medications no longer provide adequate relief.

Patients whose quality of life is significantly impacted: When knee pain prevents you from basic activities like walking, sleeping, or climbing stairs.

Generally healthy individuals: Those who can tolerate surgery and participate in rehabilitation.

Patients with realistic expectations: Understanding that surgery is not a return to a “perfect” knee, but a significant improvement.

Questions to Ask Your Chicago Doctor

Whether considering surgery or non-surgical options, ask:

About Your Condition

What stage is my arthritis?
Is my condition likely to progress?
What is causing the most pain?

About Non-Surgical Options

What non-surgical treatments would you recommend first?
How long should I try conservative care before considering surgery?
Do you offer imaging-guided injections?
What results can I realistically expect?

About Surgery

Am I a candidate for partial or total knee replacement?
What are the risks given my health history?
What can I expect during recovery?
Will I be able to return to my activities?
How many knee replacements do you perform annually?

Chicago Resources for Knee Arthritis

Chicago offers exceptional medical care for knee arthritis:

Academic medical centers: Northwestern, Rush, University of Chicago, Loyola, and UIC all have specialized joint programs.

Specialty orthopedic practices: Numerous practices throughout Chicagoland focus exclusively on joint conditions.

Physical therapy: Chicago has hundreds of PT clinics, including those specializing in post-surgical and arthritis rehabilitation.

Pain management: Multiple pain management practices offer injection therapies and comprehensive pain care.

Making Your Decision

There is no one-size-fits-all answer to the surgery vs. non-surgical question. The right choice depends on:

The severity of your arthritis
How much your symptoms affect daily life
Your age and overall health
Your activity goals
Your personal preferences about surgery
What treatments you have already tried

The good news: You do not have to decide alone. Chicago’s orthopedic specialists can help you weigh your options and develop a personalized treatment plan.

A Step-by-Step Approach

Most orthopedic guidelines recommend this general approach:

Step 1: Start with conservative care

Physical therapy
Weight management
Activity modification
Over-the-counter medications

Step 2: Add injection therapies if needed

Hyaluronic acid injections
Cortisone injections for flare-ups

Step 3: Continue conservative care as long as it works

Many patients maintain quality of life for years with non-surgical treatments

Step 4: Consider surgery when conservative options no longer provide adequate relief

Discuss timing with your surgeon
Choose the right procedure for your situation

Frequently Asked Questions

How do I know if my arthritis is bad enough for surgery?

The decision is not based solely on X-rays. Your pain level, functional limitations, and quality of life matter most. Some patients with severe X-ray findings do well with conservative care, while others with moderate findings struggle significantly.

Can I avoid knee replacement entirely with injections?

For some patients, yes. Hyaluronic acid injections can delay knee replacement for years. However, injections cannot reverse arthritis, and some patients will eventually need surgery regardless of non-surgical treatments.

What is the average age for knee replacement in Chicago?

The average age nationally is about 65-70, but replacements are performed on patients from their 40s to their 90s. Age alone does not determine candidacy.

Are there new treatments that might help me avoid surgery?

Research continues on regenerative treatments like stem cells and PRP. While promising, these are not yet proven to reverse arthritis. Currently, the most effective non-surgical options remain physical therapy and hyaluronic acid injections.

How long do I have to wait between trying injections and getting surgery?

There is no required waiting period. However, most surgeons want to see that you have tried conservative options first. If injections provide even modest relief, it suggests your knee may respond well to continued non-surgical care.

Not sure where to start? Take our free knee pain assessment to learn more about your condition and which treatment options might be right for you.

This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider about treatment options for your specific condition.

Last updated: January 2025