In this episode of OrthoInform, Dr. Eric Chehab and Dr. Alexander Tauchen discuss managing knee arthritis, noting that patients are often surprised by the diagnosis since the condition can remain asymptomatic until a minor injury triggers significant pain. Dr. Tauchen advocates for a "joint preservation" approach first, utilizing activity modification, weight loss, physical therapy, and injections like cortisone or visco-supplementation. While acknowledging the popularity of biologics like PRP and stem cells, he cautions that there is no clinical data proving they can regrow cartilage in "bone-on-bone" cases. Ultimately, surgery—whether a partial replacement to preserve natural ligaments or a total replacement for widespread disease—is reserved for when a patient is "sick and tired of being sick and tired" and seeks to restore their daily quality of life.