Question 1

Can knee replacement always be avoided?

Accepted Answer

No. Some patients have advanced, widespread arthritis or functional limitations for which knee replacement is the most predictable option. The purpose of a joint-preservation evaluation is to determine whether reasonable nonsurgical options remain—not to discourage appropriate surgery.

Question 2

Who may be a candidate for knee joint-preservation treatment?

Accepted Answer

A candidate may have persistent knee pain from osteoarthritis, meniscal disease, tendon or ligament injury, subchondral bone changes, instability, or another defined pain generator. Candidacy depends on symptoms, examination, weight-bearing imaging, overall health, prior treatment, and personal goals.

Question 3

What imaging should be reviewed before deciding on knee replacement?

Accepted Answer

Weight-bearing X-rays are often important for evaluating joint-space loss and alignment. MRI may provide additional information about cartilage, menisci, ligaments, tendons, bone marrow lesions, and the subchondral bone. Imaging should be interpreted together with the history and physical examination.

Question 4

Can PRP or bone marrow concentrate regrow an entire arthritic knee?

Accepted Answer

No responsible evaluation should promise that PRP or bone marrow concentrate will regrow an entire arthritic joint. Orthobiologic procedures may be considered for selected patients to address specific tissues and support function, but results vary and treatment is not appropriate for every knee.

Question 5

When is knee replacement more likely to be appropriate?

Accepted Answer

Replacement may be more appropriate when arthritis is advanced and widespread, pain remains severe despite reasonable nonsurgical care, sleep or daily function is substantially impaired, deformity or instability is significant, or joint-preservation options are unlikely to provide meaningful benefit.

Question 6

Is a second opinion reasonable before knee replacement?

Accepted Answer

Yes. A second opinion can help confirm the diagnosis, review the imaging, explain realistic alternatives, and identify when surgical consultation is appropriate. It should provide clarity without creating unrealistic expectations or delaying necessary care.

Question 7

Where are knee joint-preservation evaluations available?

Accepted Answer

Dr. Deborah Westergaard provides physician-led evaluations for patients in Dallas and Plano, Texas. A consultation is required to determine whether any treatment is medically appropriate.

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