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Non-operative Treatments

Non-operative Treatment Options: Hip

When patients come to us with varying degrees of hip discomfort our first goal is to provide pain relief through non-operative treatments. In general, we can decide based on your arthritic changes on radiographs and your duration and severity of symptoms whether non-operative treatments will be helpful. In the majority of patients, we make an attempt to help you without surgery, only if these attempts fail will we offer replacement surgery. Dr. Boettner usually recommends a combination of:

  • natural and pharmacologic anti-inflammatories
  • Cartilage nutritional supplements
  • activity modification & protective exercises
  • physical therapy for certain hip conditions
  • Injections with Cortisone, PRP or Hyaluronic Acid

We do provide injections in the comfort of our office and can usually perform the injection during your appointment saving you time and offering almost immediate pain relief to most patients. Throughout the care we will carefully monitor the progress of your cartilage damage and based on shared decision making will guide you through the sometimes difficult decision on when to proceed with surgery as well as which type of hip replacement is best for you. Should you need surgery, we will consider your individual anatomy and risks as well as desired activities and work load to decide whether or not a direct anterior or posterior total hip replacement or potentially a hip resurfacing is the best treatment for you.If you live further away from New York and are interested in treatment advise, you can schedule a telemedicine visit to benefit from our expertise without traveling to New York.


Non-operative Treatment Options: Knee

Knee pain is very common. Often this can have quite benign reasons and might only require a short course of non-operative treatments. We will carefully evaluate what caused your pain and based on injury mechanism, type of pain, clinical examination, radiographic assessment and MR-imaging identify the underlying reason for your pain. Patients with arthritis can often receive nonoperative treatments for many years. Successful nonoperative treatment should keep you comfortable, preserve your range of motion and activity level. Treatment options include:

  • NSAID non-steroidal anti-inflammatory medications
  • Natural anti-inflammatories
  • Cartilage Nutritional supplements
  • Activity Modifications
  • Physical Therapy
  • Unloader Braces
  • Injections with Cortisone, PRP or Hyaluronic Acid

Timing of a knee replacement requires careful individual guidance. While we usually don’t recommend that you wait until you cannot live with the pain any longer, we also advise against surgery during the early years of cartilage damage. Usually full thickness cartilage loss with “bone on bone” disease is required to be considered for surgery. We also carefully evaluate your range of motion, the degree of deformity and resulting ligamentous instability as well as the amount of bone loss on radiographs. Together with your response to non-operative treatments we can advise you on the best time point to move on with surgery. I personally feel that getting to know you during the non-operative treatment helps me to better guide you and develop a personalized treatment approach. Many of our patients favor partial or uni-compartmental knee replacement over total knee replacement (link total knee replacement). We today perform partial knee replacements in a substantial number of our patients, however, picking the right time point requires careful monitoring of your individual situation.

If you live further away from New York and are interested in treatment advise, you can schedule a telemedicine visit to benefit from our expertise without traveling to New York.

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