Trying to avoid replacing one or both knees but don’t know what to do about that bone-on-bone knee pain? Or are you just fed up that your knee joints are functioning like a pre-oiled Tin Man? Whatever it is, most people try to avoid having body parts replaced, for so many reasons, unless it’s completely necessary. Add to that how elective surgeries, such as knee replacement, are being delayed and canceled due to COVID-19, now is a great time to discover the top-ranking knee replacement alternatives.

That’s why we’ve put together this list of alternatives to knee replacement surgery, ranked according to third-party patient questionnaires. Some of the results may surprise you, such as, the second-highest-ranking alternative to knee replacement is a non-invasive, drug-free treatment based on a shoe – AposHealth®.

Fun Fact: Measuring the effectiveness of treatments is done by giving patients standardized questionnaires to rate the change in levels of pain and function. The impact that each treatment has had on each patient can be measured (this is called the effect size) in order to discover how effective each treatment is.

Measuring the effectiveness of knee treatments

In this post, we are going to look at how effective 17 alternatives to knee replacement surgery were rated by patients in terms of:

  • Decrease in pain
  • Improvement in function

The effectiveness of each treatment was measured in the context of clinical studies.

Fun Fact: For knee pain, the standardized measurements go off the WOMAC Index. The WOMAC Index is internationally recognized and standardized, making it possible to compare patient feedback of one treatment against another for hundreds and thousands of patients.

Overview: what we found when we compared knee pain treatments

We compared clinical data from three current professional reviews and meta-analyses, performed and published by respected third parties such as the Osteoarthritis Research Society International (OARSI).

By examining the data side by side, we made some remarkable discoveries:

  1. Knee replacement surgery did provide better results in both pain relief and functional improvement than any of its alternatives.
  2. NSAID pills (i.e. ibuprofen) was the top-rated alternative to knee replacement for its short-term pain relief and function improvements.
  3. AposHealth was the second-highest-rated alternative to knee replacement and the highest-ranked of all non-invasive treatments.
  4. AposHealth ranked higher than many invasive treatments such as cortisone shots, opioids, and intra-articular hyaluronic acid shots.


The first chart below shows how treatments were rated by patients to relieve pain, and the chart below that shows how much the treatments improved patients’ function.

At a glance: top knee treatments ranked by pain relief

(The higher the number, the greater the improvement in pain relief)

At a glance: top knee treatments ranked by functional improvement

(The higher the number, the greater the improvement in joint function)

Deep dive: the top 5 alternatives to knee replacement surgery ranked by pain relief

The highest-rated alternatives to knee replacement in terms of pain relief (compared by effect size) were:

  1. Nonsteroidal anti-inflammatory drugs (1.11)
  2. AposHealth® (0.77)
  3. Cortisone shots (0.58)
  4. Opioids (0.53)
  5. Exercises (0.49)


Pain relief score: 1.10

Nonsteroidal anti-inflammatory drugs (i.e. ibuprofen) are clinically proven to provoke a large improvement in pain relief. NSAIDs are not recommended for regular, long-term use, and the pain relief only lasts temporarily, until the effect of the drug wears off. Side effects of long-term NSAID use may include: heartburn, stomach ulcers, high blood pressure, leg swelling, headaches, and dizziness, ringing in the ears, allergic reactions, and liver problems.

2) AposHealth®

Pain relief score: 0.77

AposHealth® is based on a personalized footworn medical device that helps redistribute the pressure away from the painful area of the knee. Over time, one’s muscular control and coordination improve, resulting in significant pain relief that lasts even when you are not wearing the shoes. AposHealth risks include falling, muscle and joint soreness, and the shoes may require adjustment.

3) Cortisone Shots

Pain relief score: 0.58

Cortisone shots (aka Intra Articular Corticosteroid injections) are a form of steroid injections that are typically injected directly into a particular body part for local relief. Cortisone shots are clinically proven to relieve knee pain. The effects of a cortisone shot are more deliberate than when taken in pill form. Due to potential side effects, cortisone shots are generally only prescribed in limited amounts. Side effects of cortisone shots may include cartilage damage, weight gain, osteoporosis, puffiness of the face, and joint infection.

4) Prescription Opioids

Pain relief score: 0.53

Prescription Opioids (i.e. morphine) relieve pain by preventing cells from transmitting pain signals to the brain and only decrease pain temporarily. As your condition deteriorates and tolerance to the medication increases, you may require ever-increasing amounts to achieve the same amount of relief and, in some cases, patients won’t be able to consume enough to make the pain tolerable. Prescription opioids and other types of prescribed painkillers can be effective for short-term pain relief while seeking a long-term solution.

Opioids are highly addictive and deadly, they can cause side effects such as drowsiness, confusion, nausea, constipation, slowed breathing, stomach ulcers, heartburn, dizziness, itching, rashes, liver and kidney problems, high blood pressure, and leg swelling.

5) Exercise

Pain relief score: 0.49

Land-based exercise can improve muscle strength, relieve pain, and reduce stiffness. However, for patients with osteoarthritis, exercise should be done gradually, preferably learning home exercise from an expert such as a physical therapist who can provide guidance over time to maximize the benefits.

If you’re serious about choosing to not undergo surgery, have difficulty with exercise, or use drugs that can incur a long list of side effects, the results you’re seeing here with AposHealth® and other non-invasive treatments are worth exploring. Let’s keep reading.

Deep dive: top 5 alternatives to knee replacement surgery ranked by functional improvement

The highest-rated alternatives to knee replacement in terms of functional improvement (by effect size) were:

  1. Nonsteroidal anti-inflammatory drugs (1.02)
  2. AposHealth® (0.66)
  3. Strength training (0.41)
  4. TENS (0.34)
  5. Intra-articular hyaluronic acid (0.32)


Functional improvement score: 1.10

Nonsteroidal anti-inflammatory drugs (i.e. ibuprofen) are clinically proven to offer large improvements in knee function. However, the functional improvement is short-lived and is not meant as a long-term solution. They do not address the core biomechanical problems causing knee osteoarthritis.

2) AposHealth®

Functional improvement score: 0.66

AposHealth® is clinically proven to improve knee function by improving the muscular control of the joints in the legs, pelvis, and lower back, which has good results on your overall movement patterns. The treatment program is safe, non-invasive, and can be carried out at home for an hour a day allowing you to go about your regular day.

This video shows how knee osteoarthritis patients’ function improved with the use of AposHealth®.

3) Strength training

Functional improvement score: 0.41

Studies have shown that weak leg muscles are associated with knee osteoarthritis. Strengthening the leg muscles can improve joint control and knee function. Long-term compliance is a major factor to maintain the effects of strength training, and it is important to have professional guidance so that you do the correct exercise that best fits your body. Strength training can be a good option but requires self-discipline and time, so can be limited to patients whose lifestyle is suitable for the routines.


Functional improvement score: 0.34

Transcutaneous electrical nerve stimulation (TENS) uses electrodes placed in the area of the painful joint to send electrical pulses through the nerves. TENS machines can be purchased online and can be used at home. TENS has been shown to moderately improve joint function.

5) Intra-articular hyaluronic acid

Functional improvement score: 0.32

Intra-articular hyaluronic acid, colloquially called the ‘gel shot,’ is a type of injection that can moderately improve function. Relief can last up to 6 months. Potential side effects need to be carefully considered as with any treatment.

Now that we’ve reviewed the data, let’s look at how this applies to your life right now.

At AposHealth®, we rely on data and are constantly improving the AposHealth experience for you. If you believe surgery should be a last resort, and pharmaceuticals should only be used seldomly if really needed…if holistic living and wellbeing are important to you, AposHealth® may be the game-changer you’ve been looking for.

Where AposHealth® is available

AposHealth®, the highest-rated non-invasive, drug-free alternative to knee replacement surgery, is currently available in the US, UK, and Israel. As of the writing of this blog post, AposHealth® is available in the following US locations:

Availability is expanding rapidly, so if your state isn’t listed above, it’s still worthwhile to check location availability here, and sign up for our newsletter.

Choosing an alternative to knee replacement surgery

Each patient is different and has different goals and priorities when it comes to dealing with painful and limiting knee conditions. It’s important to weigh the medical options carefully with the advice of your physician as well. The data we’ve provided here may help you come to a decision, along with a consideration of your current medical condition, your motivation to adhere to a treatment program, and the availability of the treatments. We invite you to find out more about AposHealth® and what it can do for you.

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