Knee osteoarthritis · Conservative & surgical · Vienna
A diagnosis of knee osteoarthritis is not a verdict, and certainly not an automatic reason for surgery. There are often many good years between the first start-up pain and a replacement – if the treatment is right. As an English-speaking specialist in Vienna, I guide you through every stage: from exercise therapy and injections to, when the time really comes, the right joint replacement.
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The cartilage is your knee's gliding surface. In osteoarthritis (gonarthrosis) this layer becomes thinner and rougher over years – until, in the end stage, bone rubs on bone. Common causes: years of malalignment (bow legs or knock knees), previous injuries (meniscus, cruciate ligament), excess weight, or simply predisposition.
Important to understand: cartilage does not grow back. The goal of every treatment is therefore to protect the remaining cartilage, calm the accompanying inflammation and strengthen the muscles so they relieve the joint.
Early: start-up pain after sitting, morning stiffness, discomfort after long loading
Moderate: pain when walking and climbing stairs, recurrent swelling, shrinking walking distance
Advanced: pain at rest and at night, increasing malalignment, marked restriction of movement
Diagnosis: clinical examination + weight-bearing X-ray; MRI if accompanying damage is suspected
Conservative for as long as it gives you real quality of life – surgery only once the options below are exhausted. And then done properly.
The best-proven osteoarthritis therapy of all: targeted muscle building and joint-friendly exercise (cycling, swimming). Every kilogram less relieves your knee several times over with each step. Plus physiotherapy with a clear exercise programme.
Hyaluronic acid improves the joint's lubrication; PRP from your own blood calms the inflammation – both directly in my practice, often with months of effect. Cortisone is used only sparingly and specifically for acute flare-ups.
A "clean-out" for pure osteoarthritis offers little according to the evidence – I tell you that openly. Arthroscopy is only useful for mechanical problems: a trapped meniscus fragment, loose bodies, true locking.
If only the inner compartment is worn, a partial (unicompartmental) replacement is often enough – a smaller procedure with a more natural feel. For extensive osteoarthritis, a total replacement. Surgery date at the private hospital usually within 1–2 weeks.
No X-ray "prescribes" surgery – your symptoms decide. My rule of thumb: when the knee dictates your life – you avoid walks, wake at night, cancel plans – it is time to talk seriously about a joint replacement.
Waiting too long has downsides too: malalignment increases, muscle wastes, and the other side plus hip and back suffer from the protective posture. The art lies in the right timing – not too early, not too late.
Why patients with knee osteoarthritis come to me
No – knee osteoarthritis does not automatically need surgery, not even at 55. It starts with exercise, muscle strengthening, weight optimisation and, if needed, injections with hyaluronic acid or platelet-rich plasma (PRP). A replacement only makes sense once the conservative options are exhausted and quality of life is lastingly affected – and you help decide that moment, not the X-ray alone.
The best-proven treatments are exercise and targeted muscle strengthening – they act like an external shock absorber. Hyaluronic acid and PRP injections can relieve symptoms for months. Every kilogram of weight lost relieves the knee several times over with each step. Only when these options are exhausted does the question of a replacement arise.
For mild to moderate knee osteoarthritis, yes: hyaluronic acid improves the joint's lubrication and can relieve pain for months. In advanced osteoarthritis the effect is limited – then I advise you honestly whether the treatment is still worthwhile.
For pure osteoarthritis without mechanical symptoms, the evidence shows little benefit from a 'clean-out' arthroscopy – and I am honest about that. It is only useful for clear mechanical problems such as a trapped meniscus fragment or loose bodies in the joint.
When, despite exhausted conservative treatment, there is persistent pain (including at night and at rest), a severely limited walking distance and a clear loss of quality of life. You make the decision – my job is the honest assessment of whether the time has come.
With osteoarthritis a second opinion is especially worthwhile: I will tell you honestly whether the conservative options are truly exhausted – or whether surgery now is the right step.
The earlier osteoarthritis is treated properly, the longer you keep your own joint. Let's build your stepwise plan together, in English.
1040 Vienna: +43 1 585 62 60 · 1020 Vienna: +43 1 890 45 20
By prior appointment only · 1040 Vienna-Wieden (Große Neugasse 28/2) · 1020 Vienna-Leopoldstadt (Vorgartenstrasse 206c)