Knee Replacement Alternatives in Dallas & Plano: Robert’s Experience

People considering knee replacement may have nonsurgical options, depending on their diagnosis and structural findings. At Regen Experts in Dallas and Plano, Dr. Deborah Westergaard uses examination and imaging to evaluate candidacy for joint preservation, including PRP or bone marrow concentrate in selected patients. An evaluation cannot promise pain relief or avoidance of surgery or candidacy for knee replacement alternatives.

When walking becomes something you have to plan around your knees, the question is bigger than what an X-ray shows. It is whether you can keep exercising, use the stairs comfortably, and remain independent.

Being told that knee replacement may be in your future deserves a thoughtful response. Replacement can be the right decision. But before scheduling surgery, some patients want to understand whether reasonable nonsurgical options remain and what a more detailed evaluation might reveal.

Robert was one of those patients.

Watch Robert describe his experience with both knees

https://youtu.be/5BG2qq4gMSA

“I don’t even think about my knees anymore.”

Robert’s account, recorded in late September 2026: approximately eight months after his first knee treatment in January 2026 and four months after his second in May 2026.

About this testimonial: Robert describes his own experience after treatment. His report does not establish that BMC caused all of the improvement or prevented knee replacement, and it is not evidence of the results another patient should expect. Research does not establish a reliable expected rate of complete pain relief or avoidance of replacement after this procedure. Some patients improve, while others have persistent symptoms or ultimately need surgery.

Before treatment, walking had become difficult

Robert reports that approximately a year and a half before his testimonial, another physician told him knee replacement was a question of when rather than if. He had been told he was a candidate for replacement of both knees.

He describes pain while walking. Toward the end of a walk, his knees would begin to shake, and he sometimes had to stop and wait for the symptoms to subside.

That description matters. A person can have arthritis on imaging, but the clinical problem also includes how the knee behaves under load. Pain, a sense of instability, and difficulty completing a walk deserve an examination rather than an assumption about their cause.

I subsequently performed physician-guided intraosseous bone marrow concentrate treatment on both of Robert’s knees, with the first treated in January 2026 and the second in May.

At his late September testimonial, Robert reported that his pain was gone. He described walking approximately three miles every morning, taking additional walks on weekends, riding his Peloton, exercising freely, and navigating stairs.

His description was simple:

“I don’t even think about my knees anymore.”

Those are Robert’s reported results at that point in time. They do not tell us what his knees will be like years from now, demonstrate cartilage regeneration, or predict how someone else will respond.

What alternatives should be evaluated before knee replacement?

Reasonable options depend on the diagnosis, severity of disease, prior care, and the activities a patient wants to maintain. They may include structured exercise or physical therapy, weight management when appropriate, bracing, and suitable medications. Selected patients may also consider injections, including orthobiologic procedures.

The AAOS knee osteoarthritis guideline supports exercise and other established nonsurgical measures. It states that PRP may reduce pain and improve function, while grading that recommendation as limited.

A knee replacement consultation remains appropriate when symptoms, structural disease, and limitations make surgery the most reasonable option. Having an evaluation for other options should help clarify that decision.

At Regen Experts, my starting point is the patient’s history, examination, and relevant imaging. I want to understand what hurts, when it hurts, whether the knee is mechanically stable, and which findings actually fit the symptoms.

Our knee pain and joint-preservation page explains that broader evaluation.

Why look beyond the cartilage?

The osteochondral unit includes the articular cartilage and the subchondral bone directly beneath it. These tissues function together as part of the joint’s load-bearing system. Osteoarthritis can also involve the menisci, synovium, ligaments, and changes in alignment or mechanics.

A routine intra-articular injection places material inside the joint space. An intraosseous procedure places material within bone. When subchondral findings are clinically relevant, targeting that bone is anatomically different from simply injecting the joint.

That difference provides a rationale for evaluation. It does not establish that every arthritic knee needs a bone injection or that every MRI abnormality should be treated.

Depending on the clinical question, weight-bearing X-rays can help assess joint space and alignment. MRI may clarify meniscal pathology and subchondral findings. Ultrasound can help evaluate certain accessible soft tissues, fluid, and dynamic findings. These tools answer different questions; more imaging is useful only when it can inform the decision.

I treat the patient, not simply the picture. The recommendation follows the diagnosis.

What is intraosseous bone marrow concentrate?

Bone marrow concentrate, often called BMC or BMAC, is prepared from a patient’s own aspirated bone marrow. It contains a mixture of cells and other biologic components. It is not a purified stem cell product.

Intraosseous BMC means that the concentrate is delivered into bone. In knee care, this may involve selected subchondral targets identified through the evaluation.

Precision image guidance helps the physician identify the intended anatomy and guide placement. Depending on the target, fluoroscopy or ultrasound may be appropriate; neither replaces careful diagnosis or establishes that a treatment will work.

Robert’s treatment involved intraosseous BMC in both knees. His experience should not be described as a result of PRP, because PRP administration has not been confirmed in the information available for this article.

What does the research show, and what remains uncertain?

Research on orthobiologics needs to be read with attention to the preparation, injection location, comparison treatment, and population studied. An injection into the joint and an injection into subchondral bone are different interventions.

In a randomized study published in International Orthopaedics, Hernigou and colleagues studied 60 people with bilateral knee osteoarthritis. One knee received subchondral bone marrow concentrate, and the opposite knee received the same dose inside the joint. At an average of 15 years, replacement had occurred in 12 of 60 subchondrally treated knees and 42 of 60 knees treated intra-articularly.

That is a clinically interesting long-term finding about treatment location. It is not a personalized forecast. The study was relatively small, used a particular protocol, and did not compare subchondral BMC with a placebo or every contemporary care option. Its findings cannot establish that Robert avoided surgery because of BMC or that another patient has the same likelihood of improvement.

The AAOS recommendation on PRP remains limited. Orthobiologic preparations and treatment protocols vary, and important questions remain about who benefits, how much, and for how long.

My clinical interpretation is that subchondral bone deserves consideration when the examination and imaging support its relevance. The evidence does not justify promising cartilage regrowth, complete pain relief, or prevention of knee replacement.

How do PRP and BMC fit into an individualized plan?

PRP is prepared from a patient’s blood and concentrates platelets. BMC is prepared from bone marrow. Choosing between them requires more than comparing treatment names.

The condition being treated, intended tissue target, prior treatment response, procedural burden, and evidence all matter. PRP may be considered for selected knee or soft-tissue conditions. BMC may be considered in other selected circumstances, including an intraosseous approach when justified by the evaluation.

Neither is a universal alternative to surgery. Bone marrow aspiration and injections have risks, including pain, bleeding, and infection. Orthobiologic treatment can also fail to provide meaningful improvement. Risks, alternatives, rehabilitation expectations, and costs should be discussed before deciding on a procedure.

Our services page describes the options available across the practice.

What should a joint-preservation evaluation establish?

An evaluation should give you a clearer diagnosis and a candid explanation of the choices. It should address whether the symptoms fit the imaging, whether instability or alignment is contributing, and whether a proposed treatment has a reasonable target.

Severe deformity, major mechanical limitations, or progressive structural problems may make a surgical opinion particularly important. Other patients may have reasonable nonsurgical options to consider. Candidacy cannot be established from the phrase “bone on bone,” a testimonial, or an online questionnaire alone.

Robert’s story is meaningful because it describes what mattered to him: walking, exercising, and using his knees without constantly thinking about them. Your evaluation should begin with what matters to you, while keeping the medical evidence in view.

Considering knee replacement in Dallas or Plano?

Before scheduling knee replacement, find out whether your knee may still be a candidate for a joint-preservation evaluation.

At Regen Experts, I review your symptoms, examination, relevant imaging, and previous care to help determine whether appropriate nonsurgical options remain or whether a surgical consultation is the better next step.

Request a knee evaluation or call 214-750-6200. Please bring or arrange access to your knee imaging and prior treatment records.

Dallas consultations: 4228 N Central Expressway, Suite 101, Dallas, TX 75206.

Plano: 1400 Preston Road, Suite 120, Plano, TX 75093.

Staff will confirm the appropriate location for your evaluation and any recommended treatment.

An evaluation does not guarantee candidacy for an orthobiologic procedure or a particular outcome.

Frequently asked questions

Can I avoid knee replacement if I have osteoarthritis?

Some people can manage symptoms with nonsurgical care, while others benefit from replacement. The appropriate choice depends on pain, function, structural findings, health, and response to prior care. No PRP or BMC procedure can guarantee that replacement will be avoided.

What is different about intraosseous BMC compared with a knee joint injection?

Intraosseous BMC is delivered into bone, potentially including selected subchondral targets beneath the cartilage. An intra-articular injection goes into the joint space. These are different anatomical approaches, and bone treatment requires an individual clinical rationale.

Is bone marrow concentrate better than PRP for knee pain?

There is no universal answer. A randomized comparison of intra-articular BMC and PRP found no significant difference in measured outcomes at two years. Selection depends on the diagnosis, preparation, target, and evidence. That comparison does not establish which is preferable for a particular subchondral problem.

Does Robert’s result show that BMC prevents knee replacement?

No. Robert’s testimonial describes his reported symptoms and activities approximately eight and four months after treatment of his two knees. It does not prove prevention of replacement, cartilage regeneration, or what another patient should expect.

Am I a candidate if I have been told my knee is bone on bone?

That phrase alone cannot determine candidacy. A physician needs to assess your symptoms, examination, imaging, alignment, stability, and prior treatment response. Advanced disease may make surgery the most reasonable choice; an evaluation helps clarify the options.

Where can I have a knee evaluation in Dallas or Plano?

Regen Experts offers evaluations with Dr. Deborah Westergaard in Dallas at 4228 N Central Expressway, Suite 101, and in Plano at 1400 Preston Road, Suite 120. Intraosseous procedures are performed in Plano. Call 214-750-6200 to confirm the appropriate appointment and location.

About the author: Deborah Westergaard, MD, is double board-certified in Anesthesiology and Pain Medicine and completed an ACGME-accredited Pain Medicine fellowship at Texas Tech University. She has been practicing medicine since 1989 and brings thirty plus years of image-guided experience to physician-led spine and joint evaluation. Read her physician biography.