Medically reviewed by Charles A. DeCook, MD ·
YOUR JOINT OPTIONS · DECISION GUIDE
What can help advanced or “bone-on-bone” arthritis?
Advanced arthritis does not mean there is nothing left to discuss. Supportive care can address symptoms and daily function, while a surgical evaluation can clarify replacement. Claims that an injection rebuilds a worn joint require evidence that symptom improvement alone cannot supply.
Updated September 24, 2026 · Educational synthesis · People & medical review status
Connect the X-ray to your experience
“Bone-on-bone” is often used to describe marked joint-space loss. An image does not describe your goals, pain, sleep, walking ability, or medical risks. Bring those details into the decision rather than deciding from a label alone.
Be precise about what a treatment promises
Ask whether the measured outcome was pain, function, an imaging change, or avoidance of surgery. Those are different outcomes. An encouraging result in earlier disease does not establish the same benefit in advanced arthritis.
Examine regenerative claims closely
AAHKS advises against routine PRP, bone marrow aspirate concentrate, and mesenchymal stem-cell injections for advanced hip or knee osteoarthritis. Ask for evidence in patients like you and a clear explanation of cost and uncertainty.
Read the supporting source ↗You do not have to try everything first
For the population addressed by the ACR / AAHKS timing guideline—patients with symptomatic moderate-to-severe disease, ineffective nonoperative care, and a decision to proceed—additional mandatory nonsurgical trials are not a universal prerequisite. Individual medical optimization still matters.
Read the supporting source ↗Questions to take to your visit
- What is the goal of another nonsurgical treatment?
- Is a claim about symptom relief being presented as joint repair?
- What would make surgery appropriate or inappropriate for me?
Explore the treatment details
Compare practical expectations ↗Sources and limitations
These are selected references, not an exhaustive review. Guidelines address different populations and may disagree. Your clinician determines how evidence applies to you.
A CONVERSATION WITH A SPECIALIST
Meet the surgeons.
Explore the professional profiles of Charles A. DeCook, MD and the hip and knee surgeons at Total Joint Specialists.
Contact the practice directly about appointments, services, and coverage. A professional profile is not a personal treatment recommendation. Medical review attribution is shown separately on reviewed pages.