Alternatives to Total Knee Replacement Surgery

Were you aware that arthritis is the leading cause of knee pain and disability? From mild to severe forms of arthritis, people have varying opinions on the value of alternatives to total knee replacement surgery. When you are suffering from arthritic or injured knees, you may want a quick and drastic solution. A lot of people turn to surgery as that straightforward solve-all, but in truth surgery may barely solve one problem while creating more. Fortunately, there are plenty of alternatives to consider. Dr. Lanny’s Insoles encourages all suffering from chronic knee pain to consider these options when approaching their problem.

Alternatives to Knee Replacement

Most physicians are keen to approach lifestyle modification as a preferred alternative to knee surgery. Weight loss is a popular choice of lifestyle modification. Being just 10 pounds overweight can add up to 60 pounds of force on your knee every time you take a step. Also common is reducing activities such as running and twisting, which often compound knee injuries. Pursuing an exercise regime that is no-impact or low-impact is another sensible option. Exercise customized to your level of mobility can help you achieve your weight loss goal at the same time as it strengthens your muscles and reduces your pain. Tai chi, yoga, aerobic, and indoor cycling are all recommended by orthopedic surgeons.


Some doctors prescribe physical therapy and/or exercise to improve a patient’s strength and flexibility. Physical therapy can involve elements such as ice and heat, electrical nerve stimulation, and other exercises which increase blood flow to the knee. Strengthening exercises may include using an exercise bike, or stretching exercises such as flexing the ankle. Strengthening the leg muscles can act to help reduce many forms of knee pain. In severe cases, however, something more is needed.

Minor Surgical Approaches to Arthritis of the Knee

Knee surgery doesn’t have to be as dramatic as removing and replacing a knee joint. There are a few surgical alternatives that, while still being expensive and invasive, are less invasive than a total replacement. Arthroscopic surgery, a trail blazed by our founder Dr. Lanny Johnson, is a minimally invasive type of knee surgery performed using a camera. The camera is inserted through small incisions and can both repair cartilage and meniscus tears inside the knee, or remove bone or cartilage fragments. This type of surgery has the potential to delay or eliminate knee replacement surgery. 


The second approach is called osteotomy. It’s a type of surgical procedure on the bone itself. The surgeon makes a cut in your shin or thigh bone to shift the load away from the area of your knee suffering from arthritis. For younger patients suffering from deformity or damage on only one side of the knee, this is a desirable alternative to knee replacement. However, if this is undertaken, it can make any future knee replacement surgery more difficult to succeed with.

There is also the option of autograft arthroplasty (also known as cartilage restoration). In this procedure, arthritic knee cartilage is replaced, either with cartilage from a healthy part of the joint, or a synthetic cartilage-like substance. This is less drastic than a complete removal of the ligaments. Again, this procedure is only advised for people with arthritis in one part of their knee, not pervasive arthritis.

Non-Surgical Alternatives to Knee Surgery

There are numerous options for those seeking an alternative to knee replacement surgery. Arthritic knees are caused by inflammation in the knee, when bone rubs against bone after cartilage has been eroded away. Reduction of the inflammation in the knee’s tissue can provide a source of temporary pain relief, and delay the necessity of knee surgery. Anti-inflammatory medications such as Cox-2 inhibitors are one option to relieve the pain of knee arthritis. Over-the-counter anti-inflammatory medications (also known as NSAIDS) are well-tolerated by most patients, and can prove quite effective at offsetting pain, swelling, and stiffness associated with arthritis. Another approach is the use of corticosteroid injections. This can reduce pain through the injection of a powerful anti-inflammatory directly into the joint.

While not a drug, a supplement called glucosamine/chondroitin is thought to improve knee joints’ mobility and decrease pain caused by arthritis of the knee. This supplement may slow the deterioration of joint cartilage. It is worth bearing in mind, though, that any drug-based therapy that is undertaken is liable to have some kind of side effect, that should be considered.

Knee Replacement

A procedure called joint fluid therapy offers a solution between the limited effect medication can have, and the invasive approach of knee replacement. Joint fluid therapy is when a series of injections is made directly into the knee joints. The intention of the procedure is to improve lubrication in the knee, augmenting the synovial fluid that occurs naturally. Patients whose osteoarthritic knee pain has not had useful responses to painkillers, physical therapy, or exercise can pursue this therapy. The purified sodium hyaluronate (derived from a similar source to the knee’s own synovial fluid) will improve the knee joint’s lubrication and ability to weather shocks.

Physical Aids to Reduce Knee Pain

As well as pharmaceutical, surgical, and injection-based solutions, physical aids can also improve the quality of life of someone suffering from long-term knee pain. Braces can provide an external source of stability for knee joints. Their design allows them to stabilize a joint, reduce pain and inflammation, and strengthen the knee’s muscles. With extra pressure on the joint’s sides, the brace contributes to the joint’s realignment. This decreases contact between the rough bone surfaces, reducing pain and increasing mobility.


Another option for a physical aid is wedged insoles for arthritic knee. If you are suffering from arthritis on the inside of your knee, and possess enough range of motion to straighten and bend your knee almost straight and past 90 degrees, you may be able to benefit from this aid. Our dynamic wedged insoles take the strain off arthritic knees where the arthritis is localized simply to the inner or outer area of the knee. Unfortunately this aid will not help where arthritis has permeated the entirety of the knee joint. 

Choose Dr. Lanny's Insoles to Avoid Artificial Knee Replacement

After approximately thirty years of clinical practice as a world-recognized orthopedic surgeon, Dr. Lanny Johnson has concentrated his formidable talents on research, as well as publishing and lecturing. The main thrust of his research has been problems of the knee, particularly arthritis. He has investigated the potential for cushioned insoles to reduce the forces across the knee. This was undertaken with the intention of cushioning the knee joint from injury and protecting it from worsening arthritis.


Dr. Lanny has experienced the pain and difficulties associated with arthritis of the knee, experiencing several grave injuries while playing golf which resulted in severe arthritis. His condition continued to deteriorate. Soon he was unable to climb stairs or walk any distance at all, much less play golf, until he innovated a solution. As a surgeon he has performed many surgeries for this condition, but was motivated to find a non-operative method to delay if not prevent major surgery.  His studies showed that wedged insoles would decrease the forces across the inner knee joint. Dr. Lanny’s Insoles relieved enough of the pain from his inner knee joints that he is now able to walk 5 miles or stay on his feet 10 hours a day if needed.


If you’d like to try Dr. Lanny’s Insoles to see what they can do for your knee arthritis, give us a closer look!