Knee questions, answered
"Bone on bone" knees: is replacement your only option?
By Dr. Jill Althoff, DC, founder of Althoff Wellness Clinic in Cheyenne, Wyoming. In practice since 2003 and author of two books on neuropathy.Short answer
Being told your knee is "bone on bone" doesn't always mean you need a replacement right away. X-rays and pain don't always match: some people with severe-looking knees have little pain. Non-surgical care, such as knee decompression, aims to improve movement and comfort and may help some people delay surgery. When a knee is severely deformed or pain is extreme, a replacement may be the better choice.
What patients have usually been told
Most people who come to us with knee arthritis have heard some version of: "Your knee is bone on bone. There's nothing you can do. You'll need a replacement."
The X-ray isn't the whole story
What the imaging shows and what the patient feels don't always line up. I've seen patients whose knees look severely worn, even visibly deformed, who have very little pain. So "bone on bone" on an X-ray is a starting point for the conversation, not the end of it.
How knee decompression works
Knee decompression works on the same idea as spinal decompression. Picture the cartilage and soft tissue in the joint like a sponge that has dried out. A gentle, controlled stretch is designed to take pressure off the joint and encourage better movement and blood flow to the area, which supports the body's own healing processes.
When surgery is the better path
We're honest about this. If your knee is severely deformed, for example bowing far to one side, or the pain is extreme and isn't responding to care, a knee replacement may be the right answer, and we'll tell you so.
Why buying time can matter
Modern knee replacements often last a long time. Research suggests more than 80 percent last 25 years. But they don't last forever, and a second replacement is a bigger surgery than the first. For many people, especially those who are younger or very active, getting more good years out of their own knee before surgery can make a real difference. Results vary from person to person.
Learn more about our knee pain care in Cheyenne.
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This page is educational and is not a substitute for medical advice. Individual results vary.