What are my alternatives to knee replacement?
Compare nonsurgical knee arthritis care, injection choices, and selected surgical alternatives—with evidence, limits, and questions for your clinician.
Read the guide ↗Medically reviewed by Charles A. DeCook, MD ·
← All optionsEstablished care
Corticosteroid injection
Calm a flare. Do not confuse relief with repair.
Who might it suit?
For: A painful flare after an individual clinical assessment.
Not for: An infected joint or repeated injections without reassessment.
Limits and important cautions
The cartilage-loss trial used injections every three months for two years, not a single injection. Discuss infection risk, blood-sugar effects, and timing before surgery.
What happens, how long, and what could it cost?
- What happens
- Clinical assessment and an injection of a specified corticosteroid into the joint when appropriate.
- When might I notice a change?
- Ask when to expect the specific medicine to work and when lack of improvement should trigger review.
- How long might benefit last?
- NICE describes short-term relief of about 2–10 weeks; response varies and some people do not benefit.
- Repeat treatment
- Repeated injections require review of benefit, risks, and any planned surgery.
- Activity and recovery
- Ask who provides follow-up, what symptoms need urgent attention, and what restrictions apply to you.
- Ask for a complete estimate
- Consultation, medicine, injection, any imaging guidance, and follow-up.
Use this as a consultation guide. A timeline is not a guarantee; the evidence and FDA sections below remain part of the decision.
Source for timing information ↗THE EVIDENCE IN CONTEXT
Short-term relief; repeat-use caution
Read the 3 selected references
- NICE NG226: osteoarthritis care ↗
UK guidance on exercise, medicines, supports, and referral. Recommendations are not US coverage rules.
- McAlindon et al.: repeated triamcinolone versus saline ↗
Injections every three months for two years caused more cartilage loss without better pain outcomes. This does not establish the risk of one injection.
- Deyle et al.: physical therapy versus steroid injection ↗
In knee OA, physical therapy produced better pain and disability outcomes at one year. A specific care program was tested.
FDA status
Approved drugs · label-specific useSpecific corticosteroid drugs have approved joint-use indications. For example, Kenalog-40 labeling includes short-term adjunctive use for osteoarthritis. “Cortisone” is a category, not one interchangeable product; the formulation, route, and joint must match the relevant label or be discussed as off-label.
Site summary of FDA information · reviewed September 19, 2026. Refer to current product labeling. This is not an FDA endorsement of this site.What do professional guidelines say?
AAOS: Supports short-term relief in knee OA.
ACR: Strongly recommends knee and hip steroid injections; hip injections require image guidance.
Will Medicare cover it?
Medicare pays when medically necessary and coverage requirements are met.