Your knee is sore, and you want useful choices

Gentle movement usually helps more than staying still

A short walk or planned exercise can build leg strength. Start with movement that doesn't cause much more soreness later. During errands, a brace or cane can take some strain off. If you aren't sure what is safe, ask your doctor.

An exam shows which care matches your knee

The exam checks swelling, bending, leg strength, and the sore spot. Bring any scan reports and your medicine list. Tell the provider when soreness first showed up and which tasks increase it. The medical provider, meaning the trained person who examines you, can then judge the cause.

At QC Kinetix, regenerative treatment means a knee shot made with prepared parts of your blood. Concentrated PRP is one option, and the letters stand for platelet-rich plasma. Clinic staff take a blood sample and use a machine to spin it. A medical provider uses the platelet portion for a shot into your knee.

Some knee symptoms need prompt care

A hot, red knee with fever needs a prompt medical exam. Get quick help if you suddenly can't stand on that leg. New weakness also matters, as does a cold or pale foot. These warning signs need urgent care before a planned clinic visit.

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. At 2 years across two parallel randomised trials (200 patients, mean age 66), total knee replacement plus non-surgical treatment beat non-surgical treatment alone by 18.3 KOOS points (95% CI 11.3 to 25.3), and non-surgical treatment in turn beat written advice by 7.0 points (95% CI 0.4 to 13.5). Among patients eligible for replacement, 16 of 50 (32%) in the non-surgical group had surgery within 2 years - meaning two out of three delayed it for at least two years.

   Skou ST, Roos EM, Laursen MB, et al. — Total knee replacement and non-surgical treatment of knee osteoarthritis: 2-year outcome from two parallel randomized controlled trials.. Osteoarthritis and Cartilage, 2018. DOI: 10.1016/j.joca.2018.04.014.

4. 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.

5. A lifetime cost-effectiveness analysis using the Osteoarthritis Policy Model found total knee replacement in patients with a BMI of 40 or greater increased quality-adjusted life-years by 0.71 and lifetime medical costs by USD 25,200 in those aged 50-65, giving an incremental cost-effectiveness ratio of USD 35,200 per QALY; in those older than 65 it added 0.39 QALYs and USD 21,100 in costs. Higher complication risk in this population does not by itself make the operation poor value.

   Chen AT, Bronsther CI, Stanley EE, et al. — The Value of Total Knee Replacement in Patients With Knee Osteoarthritis and a Body Mass Index of 40 kg/m(2) or Greater : A Cost-Effectiveness Analysis.. Annals of Internal Medicine, 2021. DOI: 10.7326/M20-4722.

6. Medicare's national coverage policy states that CMS covers autologous platelet-rich plasma ONLY for patients with chronic non-healing diabetic, pressure and/or venous wounds, and only within an approved coverage-with-evidence-development clinical study. There is no Medicare national coverage for PRP in knee osteoarthritis, which is why these injections are billed to the patient as cash-pay.

   Centers for Medicare & Medicaid Services — Autologous Platelet-rich Plasma (Coverage with Evidence Development). CMS.gov, 2024.