What to try before knee surgery

What to try first for daily soreness

Begin with care you can keep doing. A physical therapist can show you safe movements and exercises for that joint. Weight loss may help when extra pounds add strain. A cane, brace, or pain gel may ease some daily jobs.

Don't judge care after one day. Watch a few real tasks, including walking, stairs, sleep, and rising from a chair. Check them again on the date set with your doctor or therapist. If they're worse, book another exam.

At QC Kinetix, orthobiologics means blood-based care prepared and given at the clinic after medical providers check your joint. PRP is the shortened name for platelet-rich plasma. A machine spins blood taken from you so one portion holds more platelets, and a needle places that portion within the sore joint. Ask about the treatment, cost, time afterward, and what happens if you decline it.

What to ask before choosing clinic care

Ask plain questions. Find out exactly what goes into your joint and who gives the care. Ask how many visits you'll need and what you'll do at home afterward. Make sure the cost and effort fit your life.

No choice fits every joint. The exam may point back to physical therapy or to a doctor who handles bones and joints. That answer still helps, though it may disappoint you. Good care doesn't push a sale.

Get help sooner for a red, hot, swollen joint with fever. After an injury, go promptly if the joint won't bend or straighten and stays stuck. Those signs aren't for home care. They need an exam without delay.

Non surgical treatment for arthritis: how to prepare for your visit

Take your X-ray if you have one. Make a medicine list and brief notes about earlier care. Tell the provider when soreness began and which movement starts it. Don't bring a long history unless they ask.

Wear loose clothes so the provider can move and check the joint. Mention swelling, night soreness, falls, and any change in walking. Name the daily job you most want back. That's enough to begin.

Arthritis may cause some of the soreness, but you still need an exam. For soreness due to arthritis, QC Kinetix offers consultations and regenerative choices using the blood-based method explained above. You'll hear whether home care, physical therapy, clinic care, or a surgery talk fits. Don't leave until you know what to do next.

Sources

1. 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.. Osteoarthritis and Cartilage, 2019. DOI: 10.1016/j.joca.2019.06.011.

2. 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.. Arthritis & Rheumatology, 2020. DOI: 10.1002/art.41142.

3. The Cochrane review of land-based therapeutic exercise for knee osteoarthritis extracted data from 54 randomised trials, assessing pain, physical function and quality of life immediately after treatment and the sustained effect at 2-6 months and beyond 6 months. Only 19 of the included studies (20%) met all three low-risk-of-bias criteria the authors applied.

   Fransen M, McConnell S, Harmer AR, et al. — Exercise for osteoarthritis of the knee.. Cochrane Database of Systematic Reviews, 2015. DOI: 10.1002/14651858.CD004376.pub3.

4. A systematic review and meta-analysis of 120 randomised trials (10,253 participants) covering resistance training across the knee osteoarthritis continuum - 88 trials in early OA, 13 preoperative, 19 after knee replacement - found improvements in mobility, walking capacity and knee extension strength in early OA (SMD 0.46-0.81, moderate-to-high GRADE), in preoperative knee extension strength (SMD 0.47, high GRADE) and in mobility after knee replacement (SMD 0.58). Resistance training improved pain, symptoms, function and quality of life in early OA but showed NO significant effect on those outcomes preoperatively, with no increased risk versus controls at any stage.

   Brown RCC, Mora-Traverso M, Fernández-González M, et al. — Efficacy and safety of resistance training for knee osteoarthritis and subsequent knee replacement: A systematic review and meta-analysis.. Annals of Physical and Rehabilitation Medicine, 2026. DOI: 10.1016/j.rehab.2026.102122.

5. A meta-analysis of seven studies (419 patients) of preoperative high-intensity strength training before total knee arthroplasty found statistically significant post-operative improvements versus control in the 6-minute walk test (pooled SMD 0.73, 95% CI 0.04 to 1.41), range-of-motion flexion (0.40, 95% CI 0.08 to 0.72), SF-36 (1.54, 95% CI 0.32 to 2.75) and WOMAC (-0.78, 95% CI -1.22 to -0.34).

   Huang ST, Yang SW. — Preoperative High-Intensity Strength Training and Outcomes After Total Knee Arthroplasty: A Systematic Review and Meta-analysis.. Sports Health, 2026. DOI: 10.1177/19417381251388638.

6. In the IDEA trial, 454 overweight and obese adults aged 55+ with pain and radiographic knee OA were randomised to intensive diet plus exercise, diet alone, or exercise alone for 18 months. Mean weight loss was 10.6kg (11.4%) with diet plus exercise, 8.9kg (9.5%) with diet alone and 1.8kg (2.0%) with exercise alone; knee compressive force and IL-6 were lower in the diet groups than the exercise-only group.

   Messier SP, Mihalko SL, Legault C, et al. — Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial.. JAMA, 2013. DOI: 10.1001/jama.2013.277669.

7. A meta-analysis of 10 randomised trials (739 patients) of valgus knee bracing for knee osteoarthritis found no statistically significant effect on VAS pain (RR -0.29, 95% CI -0.73 to 0.15, P=0.20), WOMAC function (RR -0.15, 95% CI -0.41 to 0.11, P=0.26) or KOOS, concluding that valgus bracing may have no long-term effect on pain improvement or functional activity.

   Fan Y, Li Z, Zhang H, et al. — Valgus knee bracing may have no long-term effect on pain improvement and functional activity in patients with knee osteoarthritis: a meta-analysis of randomized trials.. Journal of Orthopaedic Surgery and Research, 2020. DOI: 10.1186/s13018-020-01917-x.

8. In the SPACE pragmatic randomised trial, 240 patients with moderate-to-severe chronic back pain or hip or knee osteoarthritis pain despite analgesic use were assigned to a treat-to-target opioid strategy or a treat-to-target non-opioid strategy over 12 months. Opioids did not produce better pain-related function than non-opioid medication, and the opioid group had more adverse medication-related symptoms.

   Krebs EE, Gravely A, Nugent S, et al. — Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain: The SPACE Randomized Clinical Trial.. JAMA, 2018. DOI: 10.1001/jama.2018.0899.

9. In a 2-year double-blind randomised trial in 140 patients with symptomatic knee OA (Kellgren-Lawrence grade 2 or 3) and ultrasonic synovitis, intra-articular triamcinolone 40mg every 12 weeks produced significantly greater cartilage volume loss than saline (index-compartment cartilage thickness change -0.21mm vs -0.10mm; between-group difference -0.11mm, 95% CI -0.20 to -0.03) with no significant difference in pain.

   McAlindon TE, LaValley MP, Harvey WF, et al. — Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial.. JAMA, 2017. DOI: 10.1001/jama.2017.5283.

10. In 156 patients with knee osteoarthritis randomised in the US Military Health System, physical therapy produced a mean WOMAC total score of 37.0 at one year versus 55.8 for a single intra-articular glucocorticoid injection (mean between-group difference 18.8 points favouring physical therapy, 95% CI 5.0 to 32.6, on a 0-240 scale where higher is worse). Secondary outcomes moved in the same direction.

    Deyle GD, Allen CS, Allison SC, et al. — Physical Therapy versus Glucocorticoid Injection for Osteoarthritis of the Knee.. New England Journal of Medicine, 2020. DOI: 10.1056/NEJMoa1905877.

11. A systematic review and meta-analysis of 169 randomised trials (21,163 participants) of viscosupplementation for knee OA found clear evidence of small-study effects and publication bias. The prespecified main analysis, restricted to 24 large placebo-controlled trials with at least 100 participants per group (8,997 randomised), found a pain reduction of SMD -0.08 (95% CI -0.15 to -0.02) - the confidence interval excluding the prespecified minimal clinically important difference of -0.37.

    Pereira TV, Jüni P, Saadat P, et al. — Viscosupplementation for knee osteoarthritis: systematic review and meta-analysis.. BMJ, 2022. DOI: 10.1136/bmj-2022-069722.

12. A network meta-analysis of 149 randomised knee-osteoarthritis trials evaluating different placebo types found that intra-articular placebo produced a significant pain effect of its own (effect size 0.29, 95% credible interval 0.09 to 0.49) relative to oral placebo - meaning any uncontrolled injection appears to work partly because it is an injection, and open-label injection results systematically overstate benefit.

    Bannuru RR, McAlindon TE, Sullivan MC, et al. — Effectiveness and Implications of Alternative Placebo Treatments: A Systematic Review and Network Meta-analysis of Osteoarthritis Trials.. Annals of Internal Medicine, 2015. DOI: 10.7326/M15-0623.

13. The RESTORE trial randomised 288 community-based participants aged 50+ with symptomatic medial knee OA (Kellgren-Lawrence grade 2 or 3) to three weekly intra-articular injections of leukocyte-poor PRP or saline placebo, with participants, injectors and assessors all blinded. 93% completed the 12-month follow-up. PRP did not produce a clinically meaningful improvement in knee pain over placebo, and did not slow medial tibial cartilage volume loss on MRI.

    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.. JAMA, 2021. DOI: 10.1001/jama.2021.19415.

14. A meta-analysis of 16 randomised trials (807 participants) of intra-articular mesenchymal stem cells for chronic knee pain from osteoarthritis found that at 3-6 months MSC therapy probably produces little to no difference in pain (WMD -0.74cm on a 10cm VAS, 95% CI -1.16 to -0.33, against a minimally important difference of 1.5cm) or physical function, both moderate certainty; at 12 months, probably little to no difference in pain. MSC therapy may increase the risk of any adverse event (RR 2.67, 95% CI 1.19 to 5.99) and of knee pain and swelling (RR 1.58, 95% CI 1.04 to 2.38).

    Sadeghirad B, Rehman Y, Khosravirad A, et al. — Mesenchymal stem cells for chronic knee pain secondary to osteoarthritis: A systematic review and meta-analysis of randomized trials.. Osteoarthritis and Cartilage, 2024. DOI: 10.1016/j.joca.2024.04.021.

15. FDA states directly that regenerative medicine therapies - including stem cells, stromal vascular fraction, umbilical cord blood, amniotic fluid, Wharton's jelly, ortho-biologics and exosomes - have NOT been approved for the treatment of any orthopedic condition, naming osteoarthritis, tendonitis, disc disease, tennis elbow, back pain, hip pain, knee pain, neck pain and shoulder pain. FDA further states that being charged for these products, or being offered them outside an FDA-overseen clinical trial, means a patient is likely being deceived and offered a product illegally, and that a product's presence on clinicaltrials.gov or a firm's FDA registration does not mean the product is legally marketed. Reported harms include blindness, tumor formation, neurological events and life-threatening bacterial infections.

    US Food and Drug Administration, Center for Biologics Evaluation and Research — Important Patient and Consumer Information About Regenerative Medicine Therapies. FDA.gov, 2021.