Many patients with hip or knee arthritis tell me the same thing during their visit: “I’m not ready for surgery, but I want to feel better.”
Their symptoms are real. Joint pain, stiffness, and limitations are affecting their lives, but joint replacement doesn’t feel like the right step yet. In this scenario, patients often feel stuck, unsure of what to do next, and they become frustrated when it seems like the only options offered are to go to a different facility or to “come back when you’re ready for surgery.”
This is what I call the gray zone of arthritis care.
Arthritis Exists on a Spectrum
Arthritis is not an all-or-nothing condition. It exists on a spectrum, and not everyone with arthritis needs joint replacement right away. Some patients may never need it at all.
Unfortunately, patients in this middle space are sometimes bounced between practices or left feeling like there’s nothing meaningful to offer until surgery becomes inevitable. That can be discouraging, especially when symptoms are clearly affecting quality of life.
Joint replacement is a highly effective operation when the timing is right, but it’s also a major intervention. It shouldn’t be the default next step simply because arthritis is present.
Why Surgery Isn’t Always the First Move
I often explain arthritis care using a simple analogy.
If your car has a scratch, you don’t replace the entire door panel. You try to buff it first. It’s important to try less invasive treatments before you decide to receive a hip or knee replacement, because the joint you have may still be salvageable, and joint replacement may not be as good as the joint you were born with.
There are meaningful non-surgical options that can help manage symptoms, preserve function, and allow patients to stay active while delaying surgery until it truly makes sense. In some cases, these approaches can help patients avoid surgery altogether.
Not All Injections Are the Same
For patients in this gray zone, injections can play an important role. However, not all injections work the same way or serve the same purpose. I provide three different types of injections in my practice. Below the descriptions is a chart that highlights the main differences between these injections.
Steroid injections are designed to reduce inflammation and can be very helpful during arthritis flares. They often provide quick relief, but that relief is usually temporary.
Gel injections work differently. They improve joint lubrication and cushioning and are most commonly used in the knee. For the right patient, they can provide symptom relief that lasts several months.
Platelet-rich plasma (PRP) uses a patient’s own blood to help calm inflammation and support joint health. PRP does not regrow cartilage, but in many patients it provides longer-lasting symptom relief without damaging the joint. For the right candidate, it can be an important part of a longer-term arthritis management strategy. To learn more about regenerative medicine options at my practice, read more here.
Each of these options has a role, and the right choice depends on the joint involved, the severity of symptoms, the severity of arthritis on X-rays, prior treatments, and a patient’s goals.
You Don’t Have to Feel Stuck
If you’re not ready for joint replacement, that doesn’t mean there’s nothing that you can do. The goal is not to rush into surgery or delay it unnecessarily, but to match treatment to where you are right now, and allow you to live your life rather than waiting for an undetermined amount of time.
Non-surgical options can help patients move better, feel better, and maintain their quality of life, while preserving the ability to move forward with surgery when and if the time is right.
If you feel stuck in the middle with hip or knee arthritis, learning more about non-surgical treatment options like steroid, gel, and PRP injections is a good next step. A thoughtful conversation can help determine which approach best fits your symptoms, lifestyle, and long-term goals.
