Alternative treatment instead of knee surgery

There is a company called Kinetics that advertizes a non-surgical approach but I don't know if it is useful or not,

Yup. The classic (which bought me years) is weight loss.

I bought several years with gait modification -- my physical therapist basically worked on torque in the knees and hips so my weight was more centered as I moved. This takes a lot of dedication, because it took almost a year before my new gait became instinctive, and for the first couple of months, I needed a hip brace to nudge the hip into alignment over the knee. You want a PT practice that has experience with this -- mine did a lot of work with dancers.

The next thing I intend to ask my ortho specialist about is botox. I use botox now for migraines. She never suggested it, and it's not a first-line treatment, but it's worked in clinical trials -- not really big trials, but still, what the heck, right?

If you are prepared to get really fringy, there's stuff like stem cell injections, which I'm personally convinced are mostly expensive placebo effect (because we really don't understand how stem cells work well enough to use them insightfully), but placebo can be really powerful for pain.

I've tried biofeedback for migraine pain -- there is nothing special about the migraine aspects of this, since biofeedback is actually going after your central nervous system's perception of pain. Acupuncture really works for some people (not everyone) on pain of any sort, and this includes arthritis pain. You need to give both of these the kind of time you would give to PT before deciding if they are working -- perhaps several months of at least once a week?

I've found it helpful to realize that bone-on-bone (which I have) and pain are actually badly correlated. This means that the actual pain is being driven by aspects of our anatomy (including damage within the bone) that cannot be seen on an x-ray. Therefore, it's about going after the pain as pain.

Thank you! Very helpful. I too was diagnosed with 'bone on bone' last summer - both hip and knee. Is there a particular name for the type of PT you had? I would like to look into it.
On another note... weight loss has been helping me too (long way to go but I'm doing it!)

In addition to (slow) weigh loss, I have also been doing 2 other things since the spring of last year. I take a collagen supplement especially for joints and tendons, and SAMe (S-adenosyl-L-methionine), a supplement that has been researched for things like osteoarthritis and depression and found to be effective for some folks. So, I began taking it, and it has been really helpful. Several months after I started with this combination, when my orthopedic surgeon saw me walk AFTER the bone-on bone ex-ray results he was pretty surprised - in a good way. He was even interested in what I had been doing that helped (a surgeon!) Note: SAMe doesn't work for everyone, and dosage varies, so you have to 'experiment'. I am currently on a relatively low dose. If it's 'placebo', it's been working for almost a year now.... and I'll take it 🙂
A good and helpful summary of SAMe - uses, side effects, etc. can be found on Mt. Sinai's website. Mayo also has good information.
This is a great question! All the best in finding what works for you!

You are very welcome! I believe it's called gait retraining -- at least it's a place to start.

I've been yo-yoing my weight for my entire life, so I finally decided to go for bariatric surgery, which worked beautifully for years until I started putting the weight back on. Last summer, I started GLP-1 RAs (first zepbound, then ozempic for maintenance), lost the gain plus a bit more. It's been WAY more effective than dieting, but also, more side effects. And I know I'll be on it for life.

If you can drop enough weight to make a difference and keep it off without all that, bravo -- clearly, the healthier choice.

Arthritis foundation lists this as a good arthritis therapy. I was looking into it today but was unsure what brand is reliable quality. Can you share what you use? Thank you .

I have used a couple of different brands, based on studies done by Consumerlab. I am currently using Azendus™ Natural SAMe. I have also used Swanson brand. I do not buy from Amazon, because several of their products were found to contain little or no SAMe.
I did initially have the gastro side effects that some have, but that has lessened. And, as I mentioned, I found, through experimenting, that I could use a low dose.