You might be familiar with someone who has an unreliable knee, or perhaps you deal with this issue yourself. It’s estimated that approximately 5.4 million individuals in the UK suffer from knee arthritis, as stated by the National Institute for Health and Care Excellence (NICE). This condition is considered the most prevalent form of arthritis within the human body. These numbers equate to roughly one out of every five adults aged over 45, which makes up nearly 5 percent of the world’s population.

The requirement for efficient handling and therapy of knee issues
arthritis
It is essential to steer clear of the ‘extreme’ choice for a total knee replacement, particularly since present NHS wait times exceed one year. This should be strongly considered only as a final recourse once the pain becomes intolerable.

Dr David Thompson, an orthopaedic surgery consultant, states: “To manage knee arthritis successfully requires a comprehensive method that includes physical therapy, consistent light exercises, and keeping a healthy bodyweight to lessen pressure on joints.”

The vast array of therapies promising relief can be daunting: from chemical anti-inflammatory drugs, creams, and supplements like glucosamine, turmeric, or
cod liver oil
—to physical therapy sessions, knee braces, red light therapy, and low-impact activities like
swimming, cycling and walking
If you’re reading this, chances are you’ve likely attempted several of these methods in your effort to make descending the stairs each morning somewhat less painful.

If you’re still having difficulties, a shot-based option might be the next move before opting for total knee replacement surgery, particularly since numerous treatment options are currently available. The efficacy of these treatments primarily hinges on how severe your osteoarthritis is and your specific health situation. Our team consulted specialists and evaluated both advantages and disadvantages, taking into account whether these therapies offer long-term pain alleviation and their overall value relative to the expense involved.

Injectable treatments

Corticosteroids: £120-£200

These are commonly referred to as steroids (excluding anabolic types) and involve injecting directly into the knee joint to decrease swelling and discomfort. These treatments are available through the NHS but come with wait times of up to four and a half months. Their impact may persist for several weeks to a few months. Amongst all choices, this option is the most budget-friendly, priced at around £120-£200 per shot. Generally, their side effects such as possible bruising and flushing of the face are relatively mild.

Patients ought to experience relief from pain within two to three days; however, after about three months, any positive effects tend to diminish. Personally testing this approach in 2023, I felt somewhat let down due to the absence of significant improvements.

Is it worth trying?

If your symptoms are mild to moderate and you want to decrease inflammation, this might help alleviate the pain as well. It’s also effective for treating conditions like bursitis and nerve compression.

Hyaluronic acid: £250-£500

A jelly-like material, often applied topically to diminish wrinkles and fine lines, functions similarly to a cushion and lubricant enhancing joint mobility and decreasing discomfort, much like the natural liquid within knees. This treatment is only accessible through private means, with costs ranging from £250 to £500 per knee and can be swiftly administered. Typically, the impact on patients endures anywhere from three to six months, sometimes more. Serious side effects are uncommon; however, mild transient soreness or inflammation might happen.

In the UK, the National Health Service (NHS) does not provide this treatment mainly because of concerns over cost-efficiency and insufficient proof of lasting advantages. According to Dale Naylor, a consulting physiotherapist, “Hyaluronic acid offers the same benefits as steroid injections along with an additional padding effect.”

Is it worth trying?

More advantageous compared to corticosteroids—but accessible only through private means—and ideal for individuals eager to resume activities such as walking or running.

Platelet-rich plasma (PRP) therapy: $714-$1,143

A therapy that leverages a patient’s own blood to decrease inflammation and encourage tissue repair, Platelet-Rich Plasma (PRP) treatment has the potential to decelerate the advancement of osteoarthritis. This approach helps prevent additional harm to joint structures and minimises the necessity for surgical intervention. Beyond alleviating pain in patients, this method also enhances their overall mobility. The procedure involves placing the patient’s blood inside a centrifuge tube where it gets rapidly rotated; subsequently, substances like calcium chloride along with additives including hyaluronic acid and thrombin are added to boost platelet concentration within the plasma. Ultimately, the enriched mixture is extracted into a needle and administered directly into the knee area to kickstart recovery mechanisms.

New research indicates that approximately 70 percent of patients report significant pain reduction and enhanced functionality. Nonetheless, specialists from the Orthobiologics Clinic in Macclesfield advise that “receiving two to three platelet-rich plasma (PRP) injections could optimize outcomes for patients.” These treatments can be obtained through specific National Health Service (NHS) trusts with some waiting period or accessed privately across the United Kingdom.

Is it worth trying?

If you’re recuperating from a knee injury, PRP could be helpful in fostering recovery and easing discomfort. You should consider discussing this with your general practitioner; however, it can also be quite cost-effective if pursued independently.

Arthrosamid: £2,200-3,200

Launched in the UK marketplace in 2021, this cutting-edge hydrogel treatment targets osteoarthritis when administered directly into the knee joint. Among injection therapies available today, this particular remedy offers some of the most enduring pain alleviation benefits—potentially providing comfort for as long as four years. Former Olympian Sharron Davies counts herself among those who have experienced positive outcomes from using this product. The therapeutic effect stems from its ability to enhance the viscosity of synovial fluid—the lubricant found within joints—which shields bone endings and minimises wear through reduced friction. Additionally, it merges seamlessly with the connective tissues lining these articulating surfaces known collectively as the synovium.

This improves lubrication and provides padding. Sean Curry, a consultant at the London Orthopaedic Clinic, which offers various injection options such as Arthrosamid, notes: “While it doesn’t revert time or make your knee like new again, it significantly helps in decreasing pain.”
symptoms from arthritis
Currently accessible exclusively through private channels in the UK, its significant potential to enhance symptoms comes with a price tag ranging from approximately £2,200 to £3,200 per knee. Approximately 80 percent of patients below the age of 70 reported better pain management and increased mobility post-treatment. The best outcomes typically manifest around 13 or 14 weeks after therapy begins.

Is it worth trying?

Should your budget allow, this advanced injectable could be a great option for patients due to its prolonged impact, lasting as much as four years.

Stem cell therapy: £3,000-6,000

Considered a rising discipline in the UK, this approach has become popular as an option to conventional treatments. It helps decrease pain and enhance movement by rejuvenating injured cartilage within the knee joint. Stem cells are obtained from the patient’s bone marrow, usually sourced from the pelvic area, or derived from adipose tissues such as those found in the abdomen or thighs. These cells undergo processing at a lab and then get injected through a brief medical process.

The therapy has the potential to mend torn menisci—the cartilaginous cushions of the knee joint—while certain research indicates that stem cells might aid in healing injured ligaments like the anterior cruciate ligament (ACL).

A report by
ALT Treatment
The treatment reportedly leads to favorable outcomes for about 60-70 percent of patients. Consultant radiologist Dr Rosy Jalan suggests that further advancements are necessary before this approach can be considered a reliable option for individuals in the UK suffering from knee osteoarthritis. Potential hazards encompass inflammation, possible tissue harm, and an uncertain efficacy profile.

Various private clinics provide these treatments under the oversight of the Human Tissue Authority (HTA), which enforces strict regulations. Though costly and often not fully covered by insurance, the procedure typically costs between £3,000 and £6,000 for each knee. However, more affordable options may be available at clinics overseas in places like Mexico, India, and Thailand.

Is it worth trying?

Although many success stories can be found, potential patients ought to proceed with care since the evidence regarding its efficacy remains unclear, and possible dangers underscore the importance of thorough personal investigation.

nThe nSTRIDE autologous protein solution costs between $2,700 and $5,400 SGD.

A novel therapy called nSTRIDE, which asserts to be “the sole early intervention method aimed at addressing the root cause of osteoarthritis,” is characterized as an advanced form of PRP therapy.

The process varies because the patient’s blood undergoes treatment to increase concentrations of anti-inflammatory proteins and growth factors. Additionally, distinct from PRP, nSTRIDE involves a single administration offering outcomes that generally persist for about one to two years.

It is suggested for individuals experiencing mild to moderate symptoms. Blood is drawn from the patient’s arm and goes through several processing stages. According to Dr Damian Clark, a knee specialist based in Bristol, “In contrast to surgery, nSTRIDE is a quick process with minimal downtime required.”

The success rates differ, however research indicates that about 60-80 percent of individuals undergoing the procedure see considerable reduction in discomfort and better movement afterward. The effects may endure anywhere from half a year to 24-36 months, with each injection priced at around SGD$2,700-SGD$5,400.

Is it worth trying?

An excellent option for individuals experiencing mild to moderate symptoms, looking to recover quickly (able to go back home within an hour), and opting to pay out-of-pocket.

Prolotherapy injections: £500

Available only for private treatment in the UK, prolotherapy addresses persistent joint pain and instability affecting ligaments and tendons. The procedure involves injecting a minimal quantity of “irritant,” typically a dextrose solution, directly into the knee area to induce controlled inflammation. This inflammatory response stimulates the generation of chondrocytes—cells responsible for repairing and regenerating cartilage within the body.

Moreover, it can reinforce the ligaments, tendons, and bones surrounding the joint. Nonetheless, it typically necessitates three to four injections before showing effects, which might add up financially as each shot costs roughly £500.

Oliver Eaton, who ranks among the top experts in the UK for Prolotherapy, states, “In addition to what other injection therapies offer, this treatment aids in stabilizing ligaments. This stabilization reduces friction that could exacerbate osteoarthritis and activates the stem cells that naturally occur within a patient’s body.”

Actually, ‘prolo’ refers to the multiplication of stem cells that transform into cartilage. According to Mr. Eaton, the ProHealth Prolotherapy Clinic reported an 89 percent success rate among patients who underwent a series of three shots, with 75 percent of these individuals obtaining relief lasting between nine to twelve months.

Is it worth trying?

More affordable compared to certain injectable treatments, this option also helps patients dealing with persistent ligament or tendon issues. However, it may not be as effective for cases of severe osteoarthritis involving substantial cartilage degradation.

Four alternatives to full knee-replacement surgery

It’s essential to consult with both your general practitioner and an orthopedic specialist to establish the best course of action for your situation, taking into account factors like your age, how active you are, and the extent of knee deterioration before undergoing any surgery.

1. Arthroscopy: £3,000-6,000

This low-invasive keyhole operation is conducted under anesthesia to tackle issues like meniscal tears, ligament damages, and cartilage problems. The process usually takes between 30 to 60 minutes, during which the doctor might either eliminate or fix injured parts, including shredded cartilage, or clean away floating particles.

Many patients leave the hospital on the same day, though complete recovery can take between six to eight weeks. Personally experiencing this, as I had a meniscus tear from playing indoor soccer two decades back, I received a VHS tape of my surgery.

Jeremy Jarratt, an orthopaedic surgery consultant at Spire Healthcare in Manchester, states, “This procedure yields excellent outcomes, however, patients must pay close attention to their physical therapy and recovery process afterward.”

Available through the NHS (though privately it typically costs between £3,000-£6,000 for each knee), some potential complications include blood clots, limited mobility in the knee, and damage to nerves or blood vessels. The benefits often persist for many years, or even over a decade if the repair successfully integrates with your body. Patients under 40 generally see superior long-term results. Nonetheless, extracting portions of the meniscus raises the likelihood of developing osteoarthritis down the line; this is an issue I’ve encountered recently.

Is it worth trying?

While not always optimal for knee osteoarthritis, beneficial for other knee issues, such as meniscal tears or ligament injuries.

2. Cartilage replacement: £5,000-15,000

A person who doesn’t have osteoarthritis might still undergo cartilage repair surgery provided the damage to their cartilage is confined within a joint that remains healthy overall. This procedure comes in four varieties:

Microfracture

Keyhole surgery entails making tiny openings in the subchondral bone under the damaged cartilage. This procedure can be accessed through the National Health Service (NHS) or costs between £5,000 and £8,000 when done privately. Consultant knee surgeon Saket Tibrewal comments, “Although once considered the primary choice for repairing cartilage, current data indicates it might not be ideal for highly active people, achieving only a 50-70 percent success rate.”

Is it worth trying?

It might take up to a year for recovery, and newer, more sophisticated methods are accessible today, even though the advantages could extend beyond five years.

Mosaicplasty

Healthy cartilage along with the underlying bone is extracted and then implanted into the affected cartilage region. This procedure can be done through the National Health Service (NHS) or alternatively, you may opt for private treatment at a cost of around £8,000 to £10,000. The recovery process involves using crutches for approximately six weeks followed by resuming regular activities within two to four months.

Is it worth trying?

Expensive and significantly more intrusive compared to microfracture, Dr Ademola Adejuwon, a specialist in sports and exercise medicine, indicates that this procedure might be better for patients dealing with larger regions of cartilage damage.

Regenerative osteochondral scaffolds

Biocompatible implants are utilized to substitute for injured cartilage and bones within the knee. These may consist of products like CartiHeal Agili-C and MaioRegen. Not commonly provided through the National Health Service, these treatments typically cost anywhere from £8,000 to £15,000 when obtained privately. The success rate varies but generally falls between 70% and more than 90%, with enhanced joint functionality potentially lasting up to five to ten years.

Is it worth trying?

Experts agree that the treatment is suitable for patients aged 15 to 60 who have knee issues.

Autologous chondrocyte implantation (ACI)

Cartilage cells are extracted from a part of the knee that doesn’t bear weight, then grown in a laboratory before being put back into place. The recovery phase might extend for as long as one year, with potential issues like graft rejection or irregular cartilage development possible outcomes. This procedure is provided through the National Health Service, though it comes with a high price tag of approximately £20,000 per knee when done privately. It has reported success rates of about 80-85 percent.

Is it worth trying?

The Cartilage Clinic at University Hospital Southampton states: “ACI is considered the ‘gold standard’ for treating cartilage issues inside the knee joint,” though it can be quite costly if opting for private treatment.

3. Unicompartmental knee arthroplasty: S$14,286 – S$21,429

Known as arthroplasty or knee resurfacing, this procedure involves replacing only the damaged part of the knee joint with metal and plastic components instead of undergoing total knee replacement. This option may be available through selective funding via the NHS or comes at a cost of around £10k to £15,000 when done privately. Individuals typically go home the same day after surgery but should expect to take between three to six weeks before returning to their normal activities. Potential complications might involve issues like implant fracture or misalignment.

Is it worth trying?

Healing occurs faster compared to complete replacements, all while keeping the intact bone and cartilage undisturbed.

4. Osteotomy: From £5,000

A surgical process designed to adjust the bones within the knee joint so as to redistribute load away from the deteriorated or arthritic sections. This treatment option can be accessed through the National Health Service (NHS) and is more economical compared to alternative private therapies, with costs beginning at approximately £5,000.

The risks involve slow or incomplete bone healing, which may call for additional interventions, as well as potential damage to nerves or blood vessels. Approximately 85 percent of patients experience satisfactory outcomes ranging from good to excellent, whereas about three-quarters do not need follow-up surgeries over a decade. Dr Adejuwon recommends this procedure could be suitable for younger, more active individuals dealing with compartmental osteoarthritis or misalignments.

Is it worth trying?

Allows patients to lead a more dynamic life than with joint replacement alternatives.

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