14 Alternatives to Knee Replacement Surgery in 2023
Are you seeking alternatives to knee replacement surgery to combat nagging knee pain?
We all know how joint pain, swelling, and stiffness can hinder our daily activities.
But don’t worry; we’re diving into some non-surgical treatments for knee arthritis.
So, do these treatments truly work, and can they help you avoid knee surgery?
Let’s find out as we read on.
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If you have knee osteoarthritis, knee replacement is an option.
But it’s only sometimes immediate or suitable for everyone.
Some cannot have surgery for various reasons.
Younger patients may delay it due to the limited lifespan of artificial knees, usually 15 to 20 years.[2]Johns Hopkins
Health
“..some patients cannot undergo knee replacement surgery for various reasons. Other people with knee pain are too young for a knee replacement — the artificial knee is only likely to last 15 or 20 years…”
View in Article
Fortunately, there are several non-surgical options to relieve knee pain.
Here, we explore 14 different options for the better health of an arthritic patient.
You’ll see a range from home remedies to conventional methods to new-age non-surgical solutions.
From these, you can choose to put your faith in any that feels and fits the best.
Latest Knee Replacement Alternatives
1. Gold Injections
This new gold microbeads injection is a drug-delivery system devised by US & Danish scientists.[3]EJP
Gold micro-particles for knee osteoarthritis
“.. provided funding for this study. CNAP is supported by the Danish National Research Foundation (DNRF121) and Danish Rheumatism Association (R204-A7645). The Danish National Mass…”
View in Article
Recent research reveals that injecting gold microparticles into KOA joints reduces inflammation and alleviates pain.[4]NCBI
Gold micro‐particles for knee osteoarthritis
“…gold microparticles injected intra‐articular in KOA joints reduce inflammation and provide pain relief…”
View in Article
So, how does the new gold injection treat osteoarthritic pain?
Watch the video below, which explains the procedure and benefits of this treatment.
Alternatives to Knee Replacement Surgery: Gold Injections Treatment
Procedure for gold micro-particles injection
You will receive an intra-articular (IA) injection of 20mg gold microbeads into the affected knee joint.
Ideally, you will see pain reduction in a day or so.
However, immediate improvement in your gait is visible within 1-2 hours.
Hence, it’s an on-demand pain reliever.
In case there is no inflammation, these injected particles will remain inert.
Outcomes, risks & benefits
Outcomes, Risks & Benefits of Gold Micro-particles Injection for Osteoarthritis
The new approach comes with a set of advantages and disadvantages.
Despite the drawbacks, you will find the results are quite reliable.
Check out this list to know the benefits, risks, and expected results of the treatment:[5]EJP
Gold micro-particles for knee osteoarthritis
“The released gold ions reduce pain, joint swelling, and inflammation, and increase joint mobility…The gold ions do not spread from the gold implants and therefore the toxic effects of implants are believed to be absent…”
View in Article
Benefits
- Non-invasive: No scar, less pain
- No blood transfusion: Low infection risk
- Non-immune-suppressing: No risk of infection
- Fast-acting: Quick recovery
- One sitting (under 30 min): Time-saving
- One-time: Saves on cost, time
- Pure gold: Non-toxic, unlike other gold injections
- Low price: Save money
Risks
- Not yet approved by FDA
- Long-term results not available
Outcomes
- Reduced friction between bones while moving
- Alleviates knee pain
- Less inflammation & swelling
- Provide long-term relief
- Improves joint mobility
DMARD Gold Injections Vs. New Gold Micro-Particles Injections
Not to be confused with older DMARD gold injections for rheumatoid arthritis!
They reduce the immune system’s response.
Therefore, older gold injections cannot be a long-term treatment due to the increased risk of infection.[6]Medical News Today
What are gold injections?
“..like other DMARDs, gold injections reduced the immune system’s response. As they suppressed the immune system to stop inflammation, they also increased the risk of infection….”
View in Article
Connect with our team to know more about new gold therapy.
2. Stem Cell Therapy
Stem cell therapy uses the body’s natural healing processes to repair and slow tissue deterioration, including cartilage.
Stem Cells for Chronic Pain
Recent studies demonstrate its effectiveness in treating mild, moderate, and severe knee osteoarthritis.[7]Future Medicine
Real-world evidence of mesenchymal stem cell therapy in knee osteoarthritis
“… results showed reproducible positive outcomes in the treatment of mild, moderate and severe knee OA with long-term sustained improvements…”
View in Article
However, it’s important to note that the US FDA has not yet approved stem cell therapy for arthritis.[8]Arthritis Foundation
Considerations for stem cell interventions
“It’s important to know that no stem cell interventions are currently approved by the FDA for any type of arthritis or joint injury, a…”
View in Article
Like many investigational therapies, further research is required to establish its benefits.
3. Platelet Rich Plasma (PRP) Therapy
Platelets are rich in growth factors, hence help to treat the knee.
How is it performed?
PRP therapy involves three steps:
Step 1: Draw blood from the patient
Step 2: Extract platelets from the whole blood
Step 3: Injecting these in the knee joint
Research indicates PRP is effective for mild to moderate knee osteoarthritis.[9]OrthoInfo
Platelet-Rich Plasma (PRP)
“PRP does appear to be effective in the treatment of certain chronic tendon injuries and low- to moderate-grade knee osteoarthritis..”
View in Article
It offers pain relief and improved activity levels for a year after one injection.[10]Forbes
Platelet Rich Plasma: Everything You Need To Know
“PRP was not only able to reduce knee pain, but patients were also able to increase their level of activity for a full year after a single injection..”
View in Article
However, the evidence of its efficacy is insufficient & requires more research.
Ultrasound-guided PRP
4. Prolotherapy
In prolotherapy, the physician injects dextrose solution into the affected area.
This solution stimulates the healing by increasing the blood flow to that area.
It’s often called “regenerative injection” or “proliferation therapy.”
Research shows that prolotherapy reduces pain and stiffness.[11]Orthopedic Reviews
A Comprehensive Update of Prolotherapy in the Management of Osteoarthritis of the Knee
“Prolotherapy appears to be a safe treatment alternative that has been shown to improve stiffness, pain, function, and quality of life in osteoarthritis of the knee..”
View in Article
Moreover, you may see a constant and significant improvement in joint function.
While this procedure is safe, it requires more research.
Prolotherapy
Hence, the Arthritis Foundation guidelines do not recommend its use.[12]Arthritis Foundation
Prolotherapy for Osteoarthritis
“I would not recommend prolotherapy because I believe the jury is still out on its efficac…”
View in Article
You should follow your doctor’s advice to see if this can help you.
5. Hyaluronic Acid (HLA) Injections
Hyaluronic acid is similar to a substance naturally found in joints.
It acts as a lubricant and shock absorber for the joints, ensuring their proper function.[13]Mayo Clinic
Hyaluronic Acid (Injection Route)
“Hyaluronic acid is similar to a substance that occurs naturally in the joints. It works by acting like a lubricant and shock absorber in the joints and helps the joints to work properly.”
View in Article
It’s injected directly into the knee joint, typically around 2 ml.[14]Arthritis Health
Hyaluronic Acid Injections for Knee Osteoarthritis
“..a small amount of hyaluronic acid, often just 2 mL, is injected directly…”
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Despite being the most researched joint injection, rigorous studies have yet to demonstrate significant patient benefits.[15]STAT News
Common injections don’t help knee osteoarthritis
“The therapy is the most investigated joint injection in the field, and yet no rigorous studies have shown a significant benefit to patients,”
View in Article
Thus, the Arthritis Foundation guidelines do not currently recommend their use.[16]Rheumatology
Arthritis Foundation Guidelines for Hand, Hip, and Knee Osteoarthritis
“..hyaluronic acid injections are strongly recommended against in patients with hip OA. Evidence about the lack of benefit of hyaluronic acid injections in hip OA is of higher quality.”…”
View in Article
HLA Injection
Hyaluronic Acid (HLA) Vs. Gold Injection
Compared to HLA, the gold injections can be a better alternative for you.
Doctors use HLA injections to provide symptomatic pain relief for osteoarthritic patients.
On the other hand, gold injections focus on treating the underlying OA condition.
6. Genicular Artery Embolization (GAE) – Minimally invasive
GAE is one of the non-surgical alternatives to knee replacement surgery.
This minimally invasive procedure is performed by an Interventional Radiologist (IR).
GAE restricts blood flow to inflamed knee linings.[14]NCBI
GAE for treatment of knee osteoarthritis pain
“..minimally invasive, nonsurgical intervention…The procedure treats knee OA pain by reducing synovial blood flow,…”
View in Article
This reduces inflammation and may alleviate or eliminate knee pain in osteoarthritis.
In 2020, a study found it effectively reduced knee pain, especially in those with moderate to severe knee pain.[15]NIH
GAE for the Treatment of Knee Pain Secondary to Osteoarthritis
“..GAE to treat knee pain secondary to OA can be performed safely and demonstrates potential efficacy. Twenty patients with radiographic knee OA and moderate-to-severe pain..”
View in Article
Genicular Artery Embolization
However, there’s limited evidence on the safety and effectiveness of GAE for knee osteoarthritis.
Only three systematic reviews have been published on this topic so far.[16]NCBI
GAE for treatment of knee osteoarthritis pain
“Current evidence regarding the safety and effectiveness of GAE for treatment of knee OA is limited, with only three systematic reviews published to date ”
View in Article
7. Unispacer – Minimally Invasive
A Unispacer or Unicondylar Interpositional Spacer is one of the less invasive alternatives to knee replacement surgery.
An Unispacer is a device inserted into the affected knee joint.[17]eMedicine Health
Minimally Invasive Knee Replacement
“A unispacer is a device inserted into the diseased knee joint. It acts like a spacer, or shim, to separate the worn-out knee surfaces. …”
View in Article
It serves as a spacer to separate worn knee surfaces.
It doesn’t require cutting bone and cementing an implant.[18]NIH
The unicompartmental knee implant UniSpacer™: Ten-year outcomes
“It requires no bone cuts or component fixation…”
View in Article
However, only a few individuals are eligible for this device.[19]eMedicine Health
Minimally Invasive Knee Replacement
“..few people actually meet the requirements for a device …”
View in Article
A recent study revealed a 53% 10-year survival rate for the Unispacer.[20]NIH
The unicompartmental knee implant UniSpacer™: Ten-year outcomes
“The ten-year survival was limited (53%).”
View in Article
Unispacer
Patients with the implant experienced satisfactory clinical outcomes.
Its affordability and ease of insertion make it a viable alternative for those unfit for major surgery.[21]NIH
The unicompartmental knee implant UniSpacer™: Ten-year outcomes
“..Clinical outcomes were satisfactory in the patients who still had their implants. The low cost and simplicity of insertion may make this implant a reasonable alternative for patients with contraindications to very major surgery..”
View in Article
8. Radiofrequency Ablation (RFA) – Minimally Invasive
RFA controls knee pain by destroying the sensory nerves that transmit pain signals from the knee to the brain.
Its non-invasive nature and low complication rate make it an excellent alternative to knee replacement surgery.
Research indicates RFA is safe and effective for osteoarthritis pain and knee function.
The procedure is approved by the FDA.
Despite its popularity, there’s insufficient reliable evidence to support its use.
Also, it’s often a temporary fix.
Nerves tend to regenerate within 6 months to 2 years, potentially causing pain to return.
RFA
Source: Johns Hopkins Medicine,[22]Johns Hopkins Medicine
Knee Replacement Alternatives to Consider
“ Radiofrequency ablation controls pain in the knees by destroying the sensory nerves that carry the pain signal from the knee to the brain. RFA is likely a temporary fix, as nerves will grow back in six months to two years, and the pain may return.”
View in Article Sage Journals,[23]SAGE Journals
Efficacy and safety of RFA for treatment of knee osteoarthritis
“Its noninvasive nature and low complication rate make it a more advantageous technique than other conservative treatments. However, despite the popularization of RFA, there is a lack of reliable evidence to support its use”
View in Article NBC News[24]NBC News
‘Cool’ New Knee Procedure Eases Arthritis Pain Without Surgery
“ Because it was just approved by the FDA in April, the treatment is not widely available yet, but pain centers across the country are beginning to offer it.”
View in Article
Conventional Knee Replacement Alternatives
9. Medication and Steroid Shots
NSAIDs may reduce pain, inflammation, and swelling.
However, its prolonged consumption may cause stomach ulcers, kidney damage, and gastrointestinal bleeding.
OTC drugs may also help manage pain.
Another option is Corticosteroid injections. This can reduce knee pain and inflammation.
Medication and Steroid Shots
Pain relief works for 1 to 6 weeks, but no evidence of lasting relief.
Source: NCBI,[25]NCBI
Safety of Oral Non-Selective Non-Steroidal Anti-Inflammatory Drugs in Osteoarthritis
“All non-steroidal anti-inflammatory drugs (NSAIDs) have the potential to induce adverse events… including gastrointestinal ulcers and bleeding (COX-1), hypertension and”
View in Article Rheumatology Advisor[26]Rheumatology Advisor
Arthritis Foundation Guidelines for Hand, Hip, and Knee Osteoarthritis
“..corticosteroid (CS) injections have been repeatedly found to offer rapid onset pain relief, they have not demonstrated long-term effects…..NSAIDs are conditionally recommended for patients with hand OA…”
View in Article
10. Acupuncture (Therapeutic Option)
Acupuncture uses thin, sharp needles to alter the energy flow within the body.
It brings relief from joint pain and has a low risk.
Research suggests it can provide short-term relief (up to 13 weeks) for severe osteoarthritis.[27]Verywellhealth
How Acupuncture Helps Knee Pain
“acupuncture may help provide pain relief on a short-term appears to provide short-term pain relief (up to 13 weeks) in patients with chronic knee pain caused by osteoarthritis….”
View in Article
The Arthritis Foundation guidelines support its use.[28]Rheumatology Sdvisor
Arthritis Foundation Guidelines for Hand, Hip, and Knee Osteoarthritis
“Acupuncture is conditionally recommended for patients with knee, hip, and/or hand OA.”
View in Article
Acupuncture
11. Physical Therapy – Yoga and Other Exercises
Physical therapy aims to reduce pain and strengthen knee muscles.[29]Healthline
Alternatives to Knee Replacement Surgery
“… reduce pain and strengthen the key muscles that affect your knees. They can also work with you to make sure you’re doing the exercises correctly. They may apply ice and heat to reduce pain and inflammation.”
View in Article
A physical therapist will guide you to ensure you do the exercises correctly.
The therapy approach may include
- Ice and heat application
- Neuromuscular training
- Strengthening exercises
- Stretching exercises
Yoga
12. Assisting Aids
Assisting aids include walking canes and braces.
These devices perform the following functions:
- Strengthen the knee muscles
- Improve mobility
- Better stability and support
- Help prevent knee pain and inflammation from getting worse.
Knee Brace
13. Ancient Medicine (Ayurveda)
Ayurveda treatment involves a combination of massage, meditation, exercise, and a nutritional diet.
However, it is an individualized treatment according to the patient’s condition.
Ayurveda naturally revives damaged cartilage and prevents further deterioration in the knee joint.[30]Namayush.gov
OSTEOARTHRITIS
“Ayurvedic treatment of Osteoarthritis prevents further deterioration in the joints and rejuvenates damaged cartilages”
View in Article
Recent research found that Ayurveda notably improved knee pain and function in severe osteoarthritis (Grade IV).[31]ResearchGate
Ayurvedic Management of Osteoarthritis Knee with Grade IV Severity and Obesity
“ After the course of treatment, the patient felt much better with knee joint pain, swelling, and stiffness, and was able to walk without support and without pain for 500 m, able to climb stairs, and do minor household work…”
View in Article
Leg Massage – Ayurveda
14. Weight-Loss Strategy
Obesity can put excess stress on the knee joint.
When walking on level ground, your knees endure 1.5 times your body weight.
So, a 200-pound person exerts 300 pounds of pressure with each step.
Research shows that a 10- to 15-pound weight loss in obese young individuals significantly reduces their future risk of osteoarthritis.
Bariatric surgery can also reduce excessive load on weight-bearing joints.
This can help reduce osteoarthritic symptoms such as difficulty walking and joint pain.
Diet Plan for Weight Loss
Source: Harvard Medical School[32]Harvard Medical School
Why weight matters when it comes to joint pain
“..the force on your knees is the equivalent of 1½ times your body weight….200-pound man will put 300 pounds of pressure on his knees….research has proven that a sustained 10- to 15-pound weight loss in obese young people can translate to a much lower risk of osteoarthritis later in life. ”
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Surgical Alternatives to Knee Replacement Surgery
Osteotomy
Osteotomy involves removing weight from the affected part of the knee.
Hence, this weight shift helps in relieving symptoms.
This procedure helps if there is less damage on only one side of the knee.
However, it works more on younger people.[33]ScienceDirect
Management of knee osteoarthritis using percutaneous high tibial osteotomy for correction of genu varum deformity in adolescents and young adults
“..most effective treatment for genu varum deformity and medial knee discomfort in teenagers and young active adults, after failure of conservative treatment…”
View in Article
Knee Osteotomy
Arthroscopy
Arthroscopy can repair a meniscus tear, ligament, bone, or cartilage inside the knee.
It involves the use of a camera inserted through small incisions.
Still, this technique may only help for some types of knee problems.
It’s possible to go home a few hours after the procedure.
Knee Arthroscopy
Not sure if you want to go for surgical alternatives to knee replacement surgery?
Get your case medically reviewed by our team of doctors.
Connect with us and avail your first virtual consultation with the doctor for free.
Alternatives to Knee Replacement Surgery Compared
When considering alternatives to knee replacement, you have various options.
Each comes with its price tag.
Physical therapy & medications are budget-friendly, but their effectiveness varies.
Injections like corticosteroids, HLA, PRP, and stem cell therapies offer potential pain relief but come at a higher cost.
Braces & supports are cost-effective & less invasive, though their effectiveness can differ.
It depends on your knee’s condition, health, and budget, so consult your doctor for the best plan.
The table below compares the costs of some popular knee surgery alternatives.
Treatment | Cost |
Gold injection* | $5,000 – $10,000 |
Stem Cell Therapy | $5,000 – $8,000 |
PRP Therapy** | $600 – $1,500 |
Prolotherapy** | $200 |
HLA Injections | $300 – $850 |
Medications | >$15 |
Corticosteroids^ | $120 – $140 |
Acupuncture | $75 – $200 |
Physical Therapy** | $50 – $350 |
Assisting Aids (knee brace, walking cane) | $30 – $300 |
Ayurveda** | $100 – $160 |
Osteotomy | <$6,000 |
Arthroscopy | $3,200 – $6,700 |
Genicular Artery Embolization (GAE) | $3,000 – $6,000 |
Radiofrequency Ablation (RFA) | $2,000 – $4,000 |
Knee Replacement Surgery | >$30,000 |
*First Knee: $10,000; Subsequent: $5,000 per joint, **per session, ^per shot |
Prices are case-dependent.
Knee Replacement Alternatives That Don’t Work
The Arthritis Foundation guidelines recommend people not to use:[34]Rheumatology Advisor
Arthritis Foundation Guidelines for Hand, Hip, and Knee Osteoarthritis
“Thermal interventions (locally applied heat or cold) are conditionally recommended for patients with knee, hip, and/or hand OA. Paraffin, an additional method of heat therapy for the hands, is conditionally recommended…”
View in Article
- Modified shoes and insoles
- Paraffin
- Biologics
- Iontophoresis
- Kinesiotaping
- Bisphosphonates
- Chondroitin sulfate and Glucosamine supplements
- Colchicine
- Methotrexate
- Hydroxychloroquine
- Radiofrequency ablation
- Pulsed vibration therapy
- Tramadol opioids
- TENS (Transcutaneous Electrical Nerve Stimulation)
What is the Right Time for Knee Replacement Surgery?
Already tried most of these?
Do you find a significant improvement in your symptoms?
If not, you may likely consider knee replacement surgery.
Your doctor could advise a Total Knee Replacement Surgery (TKR) or a Partial Knee Replacement Surgery (PKR).
It varies with the case. You can connect with us to find a licensed and celebrated surgeon overseas for free.
FAQs About Alternatives to Knee Replacement Surgery
How can I fix my knees without surgery?
There are several non-invasive options for addressing knee pain, even in cases of arthritis.
Here are our recommended safe and effective methods for treating knee pain without surgery
- Physical therapy (Exercise, yoga)
- Anti-inflammatory medications
- Injections (Gold ions, corticosteroid, hyaluronic acid)
- Stem cell therapy, PRP therapy, prolotherapy
- Acupuncture, ayurveda
- Braces & supports
- GAE, RFA
Can anything be done instead of knee replacement?
Before considering knee replacement, you may explore other treatment options.
Your doctor will discuss non-surgical approaches for knee repair.
These can include lifestyle changes and various pain relief methods, such as:[35]NHS
Alternatives to a knee replacement
“These may include lifestyle changes and some types of pain relief, such as:…low-impact exercise s…using walking aids…”
View in Article
- Weight loss to reduce knee strain if overweight
- Physical therapy & low-impact exercises like swimming, walking, or cycling
- The use of walking aids
- Pain relief medications, gels, or creams
- Hydrocortisone (steroid) injections for pain and swelling
What is the best alternative for knee replacement surgery?
Studies reveal that NSAIDs, weight loss, injections, and physical therapy are effective non-surgical knee OA treatments.
These options have their limitations but can work well when used together.
Knee braces are a non-invasive, non-drug option.
It can reduce pain and enhance function with minimal side effects.
Using knee braces with other non-surgical methods is vital for managing knee OA, reducing pain, and enhancing mobility.
Source: NCBI[36]NCBI
Non-operative treatment options for knee osteoarthritis
“NSAIDs, weight loss, intraarticular injections, and physical therapy have all been shown to be effective non-surgical treatment options for knee OA…. these options have some limitations, and are best when used in conjunction. Bracing for knee OA is a noninvasive, non-pharmacologic optioN….”
View in Article
The Upshot
As you can see, these 14 alternatives to knee replacement surgery save costs and alleviate symptoms.
Moreover, a lot of risks are involved in knee replacement surgery.[37]DrugWatch
Knee Replacement Complications
“..Complications of knee replacement surgery can result from surgery or a faulty implant. A loss of knee motion and pain are common complications. More severe complications requiring revision surgery include joint replacement infection, unexpected bleeding into the knee joint and prosthetic loosening…”
View in Article
In that case, why not give them a try?
Ultimately, you and your physician should determine the best possible option.
But remember, there is a great chance to return to your pain-free mobile life without knee replacement.
Contact us for more info on knee surgery alternatives.
References
- STAT News: Common injections don’t help knee osteoarthritis
- Johns Hopkins: Health
- EJP: Gold micro-particles for knee osteoarthritis
- Medical News Today: Can gold injections treat rheumatoid arthritis?
- Future Medicine: Real-world evidence of mesenchymal stem cell therapy in knee osteoarthritis
- Arthritis Foundation: Considerations for stem cell interventions
- Orthoinfo: Platelet-Rich Plasma (PRP)
- Forbes: Platelet Rich Plasma: Everything You Need To Know
- Orthopedic Reviews: Prolotherapy in the Management of Osteoarthritis of the Knee
- Arthritis Foundation: Prolotherapy for Osteoarthritis
- Mayo Clinic: Hyaluronic Acid (Injection Route)
- Arthritis Health: Hyaluronic Acid Injections for Knee Osteoarthritis
- Rheumatology: Arthritis Foundation Guidelines for Hand, Hip, and Knee Osteoarthritis
- NIH: GAE for the Treatment of Knee Pain Secondary to Osteoarthritis
- NCBI: GAE for treatment of knee osteoarthritis pain
- eMedicinehealth: Minimally Invasive Knee Replacement
- NIH: The knee implant UniSpacer™: Ten-year outcomes
- Johns Hopkins Medicine: Knee Replacement Alternatives to Consider
- SAGE Journals: Efficacy and safety of RFA for treatment of knee osteoarthritis
- NBC News: ‘Cool’ New Knee Procedure Eases Arthritis Pain Without Surgery
- NCBI: Safety of Oral Non-Selective NSAIDS Drugs in Osteoarthritis
- Verywellhealth: How Acupuncture Helps Knee Pain
- Healthline: Alternatives to Knee Replacement Surgery
- Namayush.gov: Osteoarthritis
- ResearchGate: Ayurvedic Management of Osteoarthritis Knee with Grade IV Severity & Obesity
- Harvard Medical School: Why weight matters when it comes to joint pain
- ScienceDirect: Management of knee osteoarthritis using tibial osteotomy..
- NHS: Alternatives to a knee replacement
- NCBI: Non-operative treatment options for knee osteoarthritis
- DrugWatch: Knee Replacement Complications