How to Protect Your Joints Before Considering Replacement

Explore all your options at OSSO’s Centre for Surgical & Regenerative Orthopaedics, led by Dr Karan Raj Jaggi.

Knee or hip pain that won't settle often leads to one conversation: joint replacement. For many people, though, it is not the first or only option.

If your joint is not yet worn out, there may be a way to protect it. This approach is called joint preservation. It aims to keep your natural joint working longer and to delay or even avoid replacement.

In this blog, we explain what joint preservation is, who it suits, the treatments involved, and when replacement is still the right call.

Joint preservation is an approach to joint care that treats the problem early, in the right order, so your natural joint stays in place.

Instead of waiting until replacement becomes unavoidable, it asks one question: what is the gentlest effective way to protect this joint and keep you moving?

Depending on your condition, the answer may be:

• Strengthening the muscles that support the joint
• Calming inflammation
• Supporting repair with your body's own healing mechanisms
• Rebuilding damaged cartilage

It is used most often for the knees and hips, and it works best when started early.

Dr. Karan Raj Jaggi, orthopaedic surgeon at OSSO, believes your own joint is worth protecting for as long as it can be. In his view, replacement should be the last step, not the first.

His reasoning is practical. A replacement joint typically lasts around 15 years. Have one too early, and you may face a revision surgery later in life. That is why he encourages patients, especially those under 65-70, to explore preservation before deciding on replacement.

He also stresses that preservation starts with an honest diagnosis. If your joint can be saved, the plan begins with the most conservative option that works. If it cannot, he will tell you plainly.

Knowing what strains your joints helps you act before damage becomes harder to manage.

• Age: Cartilage gradually wears down, especially after 40, or sooner with a sedentary lifestyle.
• Past injury: Old fractures, ligament or meniscus tears, and repetitive strain can speed up cartilage damage.
• Structural imbalances: Poor alignment or weak muscles put extra stress on a joint.
• Genetic and hormonal factors: A family history of arthritis, along with gender, occupation, diet, and bone density, can raise the risk.

See an orthopaedic specialist if you notice any of these, especially if they affect daily life:

• Pain during activity, after long periods of movement or at the end of the day
• Morning stiffness, or stiffness after resting
• Limited range of motion that eases with movement
• Clicking, grinding or popping when the joint bends
• Swelling around the joint
• Weakness, or a joint that gives way

Joint preservation is worth exploring if you have:

• Early to moderate arthritis: Pain, stiffness, or grinding, but the joint is not yet bone-on-bone.
• Been advised a replacement: A second opinion can show whether preservation is still possible, especially if you are under 65–70.
• A focused cartilage defect: Damage in one area of an active knee, rather than widespread arthritis.
• Partial tendon or ligament tears: Or tendon pain that hasn't settled with rest, medication or basic physio.
• Early-stage avascular necrosis (AVN): Of the hip or knee, where the aim is to keep the joint.
• An active lifestyle: You want to keep walking, running, playing sport or travelling.

One OSSO patient, S. (69), had hip arthritis. Instead of going straight to a replacement, she explored her options and chose a joint-preserving regenerative procedure to keep her own hip.

OSSO follows a step-up approach. Treatment starts with the most conservative option and moves up only when clinically needed. Every plan follows a doctor's diagnosis, usually including an examination and MRI.

Orthobiologics use your own blood or bone marrow to support healing in cartilage, tendons, and ligaments. Options include PRP (Platelet-Rich Plasma), GFC (Growth Factor Concentrate), BMAC, and mesenchymal stem cell therapy.

The concentrate is injected under ultrasound or C-arm guidance, so it reaches the exact area that needs it. It is usually a day-care procedure and suits early to moderate arthritis, partial tears, and chronic tendon problems. It works best alongside physiotherapy.

Arthritis pain doesn't always come from cartilage alone. The bone just beneath it, the subchondral bone, can develop lesions too.

Subchondral BMAC delivers a concentrate of your own bone marrow, rich in mesenchymal stem cells, directly into that bone under C-arm guidance. It suits selected patients with moderate to advanced (but not end-stage) knee arthritis.

The aim is to slow the progression of arthritis and help delay replacement. Long-term research supports this. In a 2021 randomised study by Prof. Philippe Hernigou, patients with arthritis in both knees received bone marrow concentrate in the bone of one knee and in the joint space of the other. After about 15 years, only 20% of the knees treated in the bone had needed a replacement, compared with 70% of the other knees. A 2026 follow-up study in the hip found a similar pattern: 16% of treated hips needed replacement over 15 years, against 40% with conservative care alone. Results depend on how advanced the arthritis is, and not every patient is a candidate.

When damage is limited to one area, it can often be repaired through arthroscopy (keyhole surgery). This includes cartilage and meniscus repair, and MACI (Matrix-Induced Autologous Chondrocyte Implantation), which uses your own cartilage cells to rebuild the defect.

It usually suits younger, active patients with a focused defect. Smaller incisions mean a faster recovery than open surgery.

Some conditions still need surgery. These include complete ligament ruptures in active patients, severe end-stage arthritis with major disability, and unstable fractures.

In these cases, replacement is not a failure of care. It is the right treatment. At OSSO, knee and hip replacement follows a fast-track protocol, with walking on Day 1 and going home in 2 to 3 days.

What matters is that the decision is made after an honest diagnosis, not by default.

Rehabilitation is central to protecting your joint. At OSSO, it is doctor-led and one-on-one, and covers strengthening and stretching, balance and gait training, and structured rehab after injections or surgery.

Joint preservation is not a promise that you will never need a replacement. Keep these points in mind:

• Starting early helps: Early arthritis and partial tears respond better than bone-on-bone arthritis.
• Results build gradually: Tissue repair takes time, though recovery is much faster than after open surgery.
• Treatments differ: PRP and GFC reduce symptoms and support healing but don't fully regrow lost cartilage. BMAC can help repair damaged tissue. Results vary from person to person.
• Lifestyle matters: Weight, smoking, and alcohol all affect how your body responds.

Book a consultation with OSSO's orthopaedic specialists, or learn more about joint preservation at OSSO. You'll get a clear diagnosis, an honest answer on whether surgery is needed, and a plan that starts with the most conservative option that works.