Modulating KNee Pain - When to operate

Introduction: Knee Pain is Common – But When is Surgery the Right Answer?

Knee pain is one of the most common complaints I see in my clinic. From avid sportspeople to those simply trying to enjoy a walk with the dog, it can seriously impact your lifestyle. The big question most people have is: “When do I need an operation?”

Here at Wessex Knee, my special interests lie in sports knee injuries, partial knee replacement, and patellar resurfacing — all targeted treatments designed to ease pain, protect function, and let you stay active.

✅ First Steps: Modulating the Pain

Before jumping into surgery, most people can manage knee pain with a personalized plan:

• Physiotherapy and targeted exercises – Strengthening the muscles around the knee can help offload painful joint surfaces.

• Weight management – Reducing weight can decrease pressure across the knee joint by up to 4–6 times your body weight with each step (Messier et al. Arthritis Rheum. 2013).

• Activity modification – Avoid high-impact activities that flare pain; switch to cycling or swimming for fitness.

• Medications and injections – Anti-inflammatory medication, steroid injections, or newer therapies like platelet-rich plasma or Arthrosamid can help control inflammation.

In most cases, these strategies help delay or even prevent surgery — and that’s always my first aim.

🏥 When Should You Consider Surgery?

Despite these conservative measures, some knees simply won’t play ball anymore.The most common signs you might need surgical intervention are:

• Pain that wakes you up at night.

• Significant swelling and stiffness limiting your daily life.

• Mechanical symptoms like locking or giving way.

• Failed physiotherapy and injections after 3–6 months.

• Imaging confirming structural damage, such as cartilage wear or bone-on-bone arthritis (Felson et al. NEJM. 2000).

When the knee joint is damaged beyond repair, procedures like partial knee replacement or patellar resurfacing offer highly targeted solutions. Unlike full replacements, these allow you to keep as much of your natural knee as possible, resulting in faster recovery and a more ‘normal-feeling’ knee.

💡 The Latest Evidence

Recent peer-reviewed research supports this selective surgical approach:

• A 2022 review in Bone & Joint Journal showed partial knee replacements deliver better function and quicker return to sport compared to total knee replacements for isolated wear.

• Patellar resurfacing, especially in active patients with anterior knee pain, reduces pain and improves outcomes long-term (Knee Surg Sports Traumatol Arthrosc., 2019).

🤔 What Can You Do Now?

If you’ve tried physiotherapy, exercises, weight loss, and injections but are still struggling with knee pain that holds you back, it might be time to speak to a knee specialist.

Your next step is simple:

• 📞 Book a consultation at Wessex Knee so we can assess you properly.

• 📝 Bring a list of your current treatments and X-rays if you have them.

• 🏃‍♂️ Be ready to plan a tailored strategy together — often that’s physiotherapy or injections first, and then surgery if it’s truly needed.

And remember — my job is to help you keep moving, pain-free, whether that’s chasing after your grandchildren or chasing your next personal best on the bike!

Conclusion:Knee pain doesn’t have to control your life. By understanding when to modulate and when to intervene surgically — guided by evidence and personal goals — we can get you back to doing what you love.

If you’d like to explore your options, don’t hesitate to get in touch with me at Wessex Knee for a friendly, expert opinion.

– Mr. Frame, Consultant Knee Surgeon