Do You Really Need a Knee Replacement? What Most People Aren’t Told About Knee Pain

Knee pain is one of the most common reasons people stop running, squatting, climbing stairs, or simply enjoying their daily lives. And yet, the message people often receive from their doctors sounds something like this:

“We’ll just monitor it until it gets worse. Then we’ll talk about a knee replacement.”

But what if you don’t have to wait for things to get worse?
And what if a knee replacement isn’t always the complete fix it’s made out to be?

In this article, we’ll break down what the research actually says about meniscus tears, knee arthritis, and non-surgical options for knee pain. We'll also explore why so many people feel stuck — and what you can do right now to take control of your joint health.

What We Commonly Hear About Knee Pain

It’s not unusual for someone with knee discomfort to get imaging (like an MRI or X-ray) that shows a meniscus tear, early arthritis, or cartilage wear.
And the response they often get?

“That’s just wear and tear. Try some light exercise. If it gets worse, we’ll consider surgery.”

This “wait and see” approach may sound cautious, but it leaves out something critical:
You can actively improve how your knee feels and functions — even with these kinds of changes.

Let’s look at what the research (and clinical experience) actually shows.

1. Knee Pain and Imaging Results Aren’t Always Connected

This surprises a lot of people: many adults have meniscus tears or arthritis on imaging but no symptoms at all.
Likewise, people with significant knee pain sometimes have only minor findings.

In other words, pain isn’t always caused by the amount of structural damage.

The good news is that your symptoms — including pain, stiffness, and weakness — can often improve even if the image of your joint doesn’t change. The human body is adaptable, and your knees are no exception.

2. Movement and Strengthening Improve Knee Function

The knee is designed to move and bear load. When it’s supported by stronger muscles, better coordination, and confident movement patterns, the joint doesn’t have to do all the work.

In fact, research shows that cartilage and meniscus tissue respond positively to load when applied appropriately. That means the right kind of exercise — done consistently and progressively — can improve joint health over time.

This is not just about managing symptoms. It’s about changing how your body functions.

3. Early Action Leads to Better Outcomes

One of the biggest mistakes we see is people waiting too long, believing they’re “just not bad enough yet” for help.

But here’s what we know:
People who address their knee pain early and commit to a structured exercise-based plan are more likely to delay or avoid surgery altogether. And for those who eventually do need surgery, they recover faster and more fully when they’re stronger going into it.

4. A Knee Replacement Isn’t Always a Complete Fix

Knee replacements are an important and often necessary intervention — especially in cases of severe osteoarthritis or significant loss of function.

But they’re not a simple swap.
Joint replacement is a major surgery that requires weeks to months of rehab, and outcomes can vary. Some people still experience discomfort, swelling, or stiffness even after the procedure.

This isn’t to scare anyone away from surgery. It’s simply to say:
If there’s a way to delay or reduce the need for it through non-surgical care, that option deserves your attention.

What the Research Says About Non-Surgical Knee Treatment

One of the most well-known studies in this area is the FIDELITY trial, which looked at people with degenerative meniscus tears. Researchers found that those who followed a structured exercise program had just as much improvement as those who underwent arthroscopic surgery — but without the risks or recovery time of an operation.

Other studies show similar results:

• Cartilage can become more tolerant to stress with progressive loading.

• Exercise improves joint alignment, movement quality, and daily function.

• The earlier conservative care begins, the better the long-term results.

So, Do You Really Need a Knee Replacement?

Maybe — someday.
But there’s a lot you can do before you reach that point. And for many people, non-surgical treatment is the most effective first step.

Our takeaway:

• Your knees aren’t broken, even if they’re not perfect.

• Your pain can change, even if your imaging doesn’t.

• You have more options than just “wait and see” or “go straight to surgery.”

Ready to Take the Next Step?

If you’re worried about the possibility of needing a joint replacement — or you’re just tired of being told to “take it easy” without real answers — we’d love to help.

At Momenta Chiropractic, we specialize in helping active adults improve knee function, reduce pain, and stay strong — without surgery or medications.
Our approach combines personalized movement assessments, targeted strength work, and hands-on care to help you get back to doing what you love.

Click the link below to start a conversation about your knees, your goals, and your next steps.