By Mr Philip Dobson, Consultant Orthopaedic Surgeon specialising in knee and hip conditions in Newcastle (Newcastle Hospitals NHS and Nuffield Health).

Knee replacement surgery is a highly effective treatment for advanced arthritis. However, many patients understandably ask:

“Is there anything I can do to delay surgery?”

In many cases, the answer is yes.

A range of non-surgical treatments can help manage symptoms, and for some patients, injection therapies may help delay the need for knee replacement, particularly in the earlier stages of arthritis.

Understanding knee arthritis progression

Osteoarthritis of the knee is a gradual process.

In the early and moderate stages, patients often experience:

• Intermittent pain
• Stiffness, particularly after rest
• Discomfort with activity
• Occasional swelling

As the condition progresses, symptoms may become more persistent and begin to affect daily activities such as walking, climbing stairs, or exercise.

Treatment is therefore aimed at managing symptoms and maintaining function for as long as possible.

Where do injections fit in?

Injection treatments are commonly used when:

• Physiotherapy and exercise alone are not enough
• Pain is limiting activity
• Patients wish to avoid or delay surgery

They can reduce pain, improve mobility, and help patients remain active.

However, it is important to understand that injections do not reverse arthritis. Their role is to manage symptoms and improve quality of life.

Types of injections

Several types of injections are used in the management of knee arthritis:

Corticosteroid injections

These reduce inflammation and can provide relatively rapid pain relief. However, the effect is usually short-term.

Hyaluronic acid injections

These aim to improve joint lubrication. Some patients benefit, although results can be variable.

Platelet-rich plasma (PRP)

PRP is prepared from your own blood and contains growth factors that help regulate inflammation and support the joint environment.

PRP has been studied extensively and is increasingly used as part of modern joint preservation strategies.

Can injections actually delay surgery?

In selected patients, injections can help delay the need for knee replacement.

This is most likely when:

• Arthritis is mild to moderate
• Pain is present but not constant
• The joint is still functioning reasonably well
• Patients remain active

By improving pain and function, injections can allow patients to maintain their lifestyle for longer before considering surgery.

Which patients benefit most?

In my practice, patients most likely to benefit from injection treatments are those who:

• Are not yet ready for knee replacement
• Wish to remain active
• Have symptoms that are impacting quality of life but are not severe
• Have not responded fully to physiotherapy alone

Treatments that aim to support the joint environment, rather than simply provide short-term relief, are often considered in this group.

When injections are less likely to help

Injection treatments are less effective in:

• Advanced “bone-on-bone” arthritis
• Severe stiffness and deformity
• Constant pain at rest or at night

In these cases, knee replacement surgery is often the more predictable and effective option.

The importance of timing

A common concern is whether it is better to delay surgery for as long as possible.

While it is reasonable to explore non-surgical options, it is also important not to delay surgery to the point where:

• Mobility becomes significantly reduced
• Muscle strength deteriorates
• Quality of life is severely affected

The decision is always individual and should be based on symptoms rather than imaging alone.

A balanced approach

In my practice, the goal is always to use the least invasive treatment that provides meaningful improvement.

For some patients, injection treatments can provide sufficient symptom relief to delay surgery.

For others, particularly with more advanced arthritis, knee replacement remains the most effective option.

The key is selecting the right treatment at the right time.

Specialist assessment

If you are experiencing ongoing knee pain and are unsure whether surgery is necessary, a specialist assessment can help clarify your options.

This allows a personalised plan to be developed, which may include physiotherapy, injection treatments, or surgery where appropriate.

The aim is always to reduce pain, improve function, and help you return to the activities that matter to you.