Physical therapy and viscosupplementation come before orthobiologics. If they have not been tried yet, they are the starting point.
Most patients arrive with their imaging and have already tried physical therapy or steroid injections. When they have not, that is where the plan begins. Physical therapy is usually covered by insurance and is one of the best-supported treatments for function.
A structured non-surgical plan usually combines activity and weight changes, targeted physical therapy, bracing or offloading, and injections, and it works best when it is matched to your specific stage of arthritis by a surgeon who can read your imaging.
Strengthening the quadriceps, hips and core stabilizes the knee and offloads the arthritic compartment. Progressive strength work is guided by a physical therapist at first.
Swapping high-impact activity for cycling, swimming or the elliptical takes pressure off the joint without deconditioning you.
An unloader brace can shift force away from the worn side of the knee in the right candidate.
When these basic treatments have not worked, orthobiologics are considered before surgical treatment. PRP works best for patients with early-to-moderate joint degeneration, active tendon or ligament injuries, or those who have not found lasting relief from physical therapy, anti-inflammatory medications, or standard cortisone injections.
When conservative care has not worked, these are considered before surgery.
A concentration of your own platelets, used as part of an orthobiologic treatment strategy for selected joint, tendon and ligament conditions.
Concentrate obtained from your own bone marrow and used in carefully selected orthopedic conditions as part of an individualized joint-preservation program.
For selected patients, Dr. Scheinberg may recommend a combination approach based on the diagnosis, imaging, severity of disease and individual treatment goals.
A consultation with Dr. Scheinberg looks at your imaging, what you have already tried and your goals, and tells you plainly what the next reasonable step is.
