6 Alternatives to Arthroscopic Knee Surgery

4. Glucosamine and chondroitin sulfate. These two dietary supplements are widely used to reduce the pain of osteoarthritis. Most rigorous studies have found they provide greater pain relief than a placebo, though it isn't clear how the supplements work or whether they can delay the progression of the disease. "They seem to work especially well during the earlier stages," says Robert Marx, an orthopedic surgeon at the Weill Medical College of Cornell University. A fact sheet from the American Academy of Orthopedic Surgeons warns consumers that quality can vary significantly among brands, since dietary supplements such as these are not heavily regulated.

5. Viscosupplementation. If traditional painkillers fail, this procedure, which involves injecting hyaluronic acid into the knee, may help. Hyaluronic acid is a substance that's normally found in the knee and helps lubricate joints and absorb shock. The procedure is relatively new; it was approved in 1997. So far, the evidence suggesting it helps is somewhat underwhelming, some experts say. Some studies show the expensive treatment offers a small benefit, while others suggest no benefit at all. Typically, treatment requires three to five $100 to $200 injections each week.

6. Total knee replacement. Though researchers are now asking tough questions about arthroscopic surgery for arthritis, they aren't questioning the value of total knee replacement for people with severe arthritis. "Total joint replacement is very effective," says Brian Feagan, one of the authors of the new study. Indeed, the number of knee replacement surgeries performed increased 65 percent between 2000 and 2006, the Agency for Healthcare Research and Quality recently reported.