Knee Osteoarthritis Treatment Without Surgery

Knee osteoarthritis (OA) is one of the most common orthopedic conditions affecting active adults. Also known as degenerative joint disease, it occurs when the protective cartilage cushioning the bones of the knee gradually wears down, causing pain, stiffness, and difficulty with everyday activities.

Treatments for knee OA have traditionally included physical therapy, anti-inflammatory medications, steroid injections, and in advanced cases, surgery. Many of these conventional approaches, however, only manage symptoms temporarily and may carry their own side effects with prolonged use.

At Palm Beach Regenerative, Dr. Ghattas offers image-guided interventional orthobiologics as a non-surgical option for appropriately selected knee OA patients. Contact us today to learn more.

Knee osteoarthritis is the gradual breakdown of articular cartilage, the smooth tissue covering the ends of the bones in the knee joint. As cartilage thins, bones are more susceptible to friction, swelling, and the formation of bone spurs, which can alter the shape and mechanics of the knee.

Research has identified that much of the pain in knee OA is driven not just by cartilage loss, but by inflammation in the bone itself. Specifically, this is a condition called bone marrow edema (BME), or bone marrow lesions (BML). This is an important distinction because it helps explain why treatments targeting inflammation may help manage symptoms even in the absence of cartilage restoration.

• Gradually worsening pain during or after activity
• Morning stiffness or stiffness after periods of rest
• Swelling around the knee joint
• Crackling or grinding sensations (crepitus)
• Reduced range of motion
• Instability or buckling of the knee
• Difficulty with stairs, kneeling, or prolonged walking

• Age-related wear and tear on cartilage
• Excess body weight placing additional stress on the knee
• Prior knee injuries or surgeries
• Repetitive stress from occupation or sport
• Hereditary predisposition
• Muscle weakness or imbalance affecting joint mechanics

Diagnosis typically involves a combination of physical examination, patient history, and imaging. Dr. Ghattas will assess your range of motion, stability, and pain patterns during your evaluation.

X-rays can reveal changes in joint space and the presence of bone spurs. MRI provides a more detailed view of cartilage, bone marrow, ligaments, and soft tissue, giving Dr. Ghattas important information about the severity of your condition and whether you are a candidate for orthobiologic treatment.

Standard care for knee OA typically includes:

• Physical therapy to strengthen surrounding muscles and improve joint mechanics
• Weight management to reduce joint load
• NSAIDs (anti-inflammatory medications) for short-term pain relief, though prolonged use carries gastrointestinal and cardiovascular risks
• Hyaluronic acid injections for joint lubrication
• Steroid injections for temporary inflammation control. Research suggests repeated steroid injections may accelerate cartilage damage over time
• Surgical options including arthroscopy, partial knee replacement, or total knee replacement, typically reserved for advanced-stage disease

For appropriately selected candidates, Dr. Ghattas offers image-guided interventional orthobiologics designed to address the underlying inflammatory processes contributing to knee OA symptoms.

Using real-time ultrasound or fluoroscopic guidance, Dr. Ghattas precisely delivers concentrated preparations of your own cells and platelets, including Regenexx Super Concentrated Platelet (SCP) or Bone Marrow Concentrate (BMC), to the affected area within the knee joint.

For patients with significant bone marrow involvement, Intraosseous (IO) injection may also be incorporated, targeting the subchondral bone layer where inflammation is often a primary pain driver.

These treatments work by supporting your body’s natural healing response, reducing inflammation, and improving the biological environment within the joint.

Important: These treatments do not regenerate or regrow knee cartilage. They are designed to manage inflammation and symptoms, with the goal of improving function and quality of life. For patients with severe bone-on-bone arthritis, joint replacement surgery may provide more complete relief. Dr. Ghattas will provide an honest assessment of all your options.

Based on Regenexx registry data, many knee OA patients report meaningful improvement in pain and function following treatment. Results vary based on the stage of arthritis, overall health, and individual response.