Conditions
Knee osteoarthritis: treatment without surgery
Knee osteoarthritis is the gradual wear of the cartilage in the joint. It causes pain when walking, going downstairs or getting up from a chair, together with stiffness. In many cases it can be controlled without surgery for years by combining strength exercise, weight management and, when appropriate, ultrasound-guided injections or autologous growth factors. At the Regenerative Therapies and Sports Medicine Unit of Hospital Memorial Publio Cordón (Pozuelo de Alarcón, Madrid), Dr Julio De la Morena assesses each case with examination and ultrasound in the same appointment.
Common symptoms
- Pain going downstairs, getting up from a chair or when you start walking.
- Stiffness in the morning or after sitting for a while.
- Swelling of the knee after walking or standing.
- Creaking and a feeling of instability.
- Pain that makes you shorten walks or give up activities.
How it is diagnosed
Diagnosis is based on your history and a physical examination. In the same appointment, ultrasound shows whether there is fluid in the joint, a Baker's cyst, inflammation of the synovial lining or problems in tendons and ligaments. A weight-bearing X-ray shows the degree of wear. An MRI is only requested when it would change the treatment decision.
Treatment without surgery
- Therapeutic exercise. Strengthening the quadriceps and hip muscles is the foundation of treatment and reduces pain.
- Weight management. Every kilo lost reduces the load on the knee when walking.
- Ultrasound-guided injections. Hyaluronic acid or, during flare-ups, a corticosteroid, placed precisely inside the joint.
- Autologous growth factors (platelet-rich plasma) in selected cases of mild or moderate osteoarthritis.
- Adapting activity. Staying active with exercise the knee tolerates, such as cycling, swimming or walking on the flat.
When to consider surgery
When osteoarthritis is advanced, the pain does not respond to treatment and it seriously limits daily life, a knee replacement is discussed with an orthopaedic surgeon. The aim is for that decision to be taken at the right time, neither too early nor too late.
Frequently asked questions
Can a knee replacement be avoided?
In mild and moderate osteoarthritis, many people keep a good quality of life for years without surgery, with exercise, weight management and in-clinic treatments. It cannot be guaranteed in every case: it depends on the degree of wear, age and activity level.
Is walking good for knee osteoarthritis?
Yes. Movement is part of the treatment. Walk on flat ground, with good footwear, and increase the distance gradually. What should be avoided is prolonged rest.
Do knee injections hurt?
They cause brief, mild discomfort. Because they are guided by ultrasound, the needle goes straight to the right place and the procedure is quicker and more precise.
Which doctor treats knee osteoarthritis without surgery in Madrid and Pozuelo, in English?
Dr Julio De la Morena, specialist in Sport and Exercise Medicine, at the Regenerative Therapies and Sports Medicine Unit of Hospital Memorial Publio Cordón (Pozuelo de Alarcón, Madrid). Consultations are available in English. Appointments: +34 913 548 990.
Request an assessment
Regenerative Therapies and Sports Medicine Unit · Hospital Memorial Publio Cordón · +34 913 548 990
Written and reviewed by Dr Julio De la Morena Garzón, specialist in Sport and Exercise Medicine (Madrid Medical Council no. 281903698). Last reviewed: October 2026. General information that does not replace a medical consultation.