Arthritis does not always require surgery. Many patients experience pain, stiffness, and functional limitations that affect daily life but are not yet ready for joint replacement. Or, they want to explore every appropriate option before considering surgery.
In my practice at the Hospital for Special Surgery, I offer a comprehensive range of non-surgical treatments to help manage hip and knee arthritis symptoms, preserve joint health, and support an active lifestyle. These treatments are designed to reduce pain, improve mobility, and help patients bridge the gap between early arthritis care and joint replacement when (or if) it becomes necessary. These are comprehensive options to manage arthritis symptoms, preserve joint health, and delay or avoid surgery when appropriate.
Who Are These Treatments For?
Non-surgical arthritis treatments may be appropriate for:
- Patients with hip or knee arthritis
- Patients whose symptoms are affecting quality of life but who are not ready for joint
replacement - Patients who feel frustrated being referred elsewhere for injections or conservative care
- Patients seeking symptom relief without accelerating joint damage
- Patients looking for a more complete, long-term arthritis management strategy
Many patients feel “stuck in the middle.” or in a “gray zone”. Their symptoms or their imaging is not severe enough for surgery, but not well-managed with basic treatments. My goal is to provide continuity of care and a full toolkit of options under one roof.
Comparing Injection Options
Before reviewing each osteoarthritis treatment in detail, it’s helpful to understand how these non-surgical options compare. Cortisone injections, gel injections, and platelet-rich plasma (PRP) differ in how they work, how often they are given, insurance coverage, and how long patients may experience symptom relief.
The chart below provides a side-by-side overview of these treatments to help patients better understand their options and have more informed discussions about which approach may be most appropriate for their hip or knee arthritis. All three treatments are performed as in-office joint injections.
Non-Surgical Arthritis Treatment Options
Cortisone (Steroid) Injections
What is it?
A corticosteroid injection that reduces inflammation inside the joint.
How it Works
Steroids are effective at calming inflammation and relieving pain inside the joint, particularly during arthritis flares. An injection can reduce swelling and irritation so the joint moves more comfortably—even though it doesn’t reverse arthritis itself. It quiets the irritated lining of the joint (the synovial membrane), so it produces less fluid and joint swelling, turning down inflammatory chemicals in the joint. Ultimately, steroids make pain nerves less sensitive and “reactive.”
How it’s Given
A single injection, typically limited to no more than once every three months.
Benefits
- Often covered by insurance
- Can provide rapid and sustained symptom relief
Considerations
- Relief is often temporary
- Repeated use over time may contribute to cartilage damage
- Best used selectively as part of a broader treatment plan
Gel Injections (Viscosupplementation Treatment)
What is it?
A hyaluronic acid injection into arthritic joints to improve joint lubrication and cushioning, most commonly used in the knee. Gel injections are not recommended for the hip.
How it Works
Viscosupplementation treatments work by improving the quality of joint fluid—making it thicker, more lubricating, and better at absorbing shock—so the joint moves with less friction and pain. They exhibit more modest anti-inflammatory effects than cortisone.
How it’s Given
- Often administered as a series of three injections, typically spaced one one to two weeks apart
- In some cases, a single-injection formulation may be used
- Treatment series are given every 6 months
Benefits
- Improvement is usually gradual over several weeks, with benefits that may last for several months.
- Often covered by insurance, though coverage varies by plan
Considerations
- Most effective for mild to moderate knee arthritis
- Not used in the hip
Regenerative Medicine: Platelet-Rich Plasma (PRP) Injections
What is it?
Platelet-Rich Plasma, or PRP, is a regenerative treatment option that uses your body’s own biology to help reduce inflammation and improve symptoms without damaging the joint. PRP is created by processing a small sample of your blood to concentrate platelets and growth factors, which are then injected into the affected joint.
How it Works
- Calms inflammation in the joint: PRP releases natural signals that reduce irritating inflammatory chemicals inside the joint.
- Decreases pain sensitivity: By lowering inflammation, PRP makes pain nerves in the joint less reactive.
- Supports remaining cartilage: PRP does not regrow cartilage, but it may help protect and support the cartilage you still have.
How it’s Given
PRP injections are performed as a scheduled procedure, similar to gel injections. A single injection is effective for most patients. PRP is used in the hip and the knee.
System Used
This system allows for precise platelet concentration and consistent preparation. The Angel System is a machine that takes a small sample of your blood, concentrates the parts of it that help healing, and gives a predictable PRP injection. It’s automated and precise, so we get a consistent, customized product to inject into your arthritic joint(s) to support your body’s own healing response.
What the Data Shows
Growing clinical evidence suggests PRP can:
- Reduce pain and inflammation in arthritis
- Provide longer-lasting symptom relief compared to steroid injections
- Avoid the cartilage damage associated with repeated steroid use
- Be more effective than viscosupplementation
Preparation and Medication Guidance
- Patients should stop NSAIDs (such as ibuprofen or naproxen) at least 7 days before PRP
- NSAIDs should also be avoided for approximately 2 weeks after the final injection, as they may interfere with the body’s healing response (Detailed instructions are provided before treatment.)
Considerations
- Most effective for mild to moderate hip and knee arthritis
- PRP is not covered by insurance
- Treatment is an out-of-pocket expense
- Results vary based on arthritis severity, activity level, and individual biology
Read more here about the regenerative medicine services I provide for hip and knee arthritis.
What to Expect
Dr. McLawhorn’s office schedules injections at specific times on specific days of the week as procedures. This allows for you to prepare for the procedure, verify insurance coverage, and procure medications, such as viscosupplementation, from specialty pharmacies, if necessary.
Before the Injection
- Medication review and preparation instructions
- Activity guidance and expectations
Day of the Procedure
- In-office injection performed under sterile conditions
- Ultrasound guidance is used to guide the needle into the joint
- Typically quick, with minimal downtime
After the Injection
- Temporary soreness or stiffness is common
- Activity modification guidance is provided
- Gradual symptom improvement over weeks, depending on the treatment used
Common Side Effects and Considerations
Most patients tolerate injections well. Possible temporary effects include:
- Injection site soreness
- Mild swelling or stiffness
- A short-lived post-injection flare, where symptoms feel temporarily worse before improving
These reactions are typically self-limited, meaning that they resolve quickly on their own without further treatment.
A Thoughtful, Long-Term Approach to Arthritis Care
Managing arthritis is not one-size-fits-all. Some patients benefit from non-surgical treatments for years, while others eventually progress to joint replacement. My approach emphasizes:
- Thoughtful patient selection
- Evidence-based treatment choices
- Clear education and expectations
- Continuity of care without unnecessary referrals
When surgery becomes the right option, patients can move forward confidently knowing they explored appropriate non-surgical alternatives.
Schedule a Consultation
If you are experiencing hip or knee arthritis symptoms and would like to discuss non-surgical treatment options—including regenerative medicine—a consultation is the best next step. I see patients in New York City and Stamford, Connecticut, and tailor treatment plans to each individual’s symptoms, goals, and lifestyle.
