In its osteoarthritis guidance, NICE (the UK’s National Institute for Health and Care Excellence) says your health and care professionals should give you relevant information in a way that is clear and understandable to you, talk with you about your options and listen carefully to your views and concerns [1].
In its osteoarthritis guidance, NICE (the UK’s National Institute for Health and Care Excellence) says your health and care professionals should give you relevant information in a way that is clear and understandable to you, talk with you about your options and listen carefully to your views and concerns [1]. This page covers what shapes a treatment choice after an ACL (anterior cruciate ligament) injury [2] or with knee osteoarthritis, which is a condition that affects the joints [1]. It is general information, not advice for one person.
- What can I ask myself before deciding?
- What affects the choice after an ACL injury?
- How is knee osteoarthritis treated?
- Do age or other health conditions rule out a referral for joint replacement?
- When is urgent help needed?
- What should I do next?
What can I ask myself before deciding?
NICE suggests thinking about what matters most to you, what worries you most, and how a treatment would affect your day-to-day life [1].
What affects the choice after an ACL injury?
After an ACL injury, AAOS (the American Academy of Orthopaedic Surgeons) says whether you need surgery depends on several factors, such as the severity of the injury, your age, how much joint wear you have, whether the knee feels unstable, and your activity level [2]. The decision about surgery begins with a conversation with your orthopaedic surgeon to set goals and review the surgical options [2].
More on non-surgical management
AAOS says non-operative management is always an option after an ACL tear [2]. It includes reducing inflammation with medications and working with physical therapy to gradually rebuild quadriceps strength and confidence in your knee [2]. AAOS also says treatment for an ACL tear will depend on the patient’s individual needs and desired goals for recovery [2].
How is knee osteoarthritis treated?
For knee osteoarthritis, NICE says the core treatments are therapeutic exercise and weight management (if appropriate), along with information and support [3]. NICE gives local muscle strengthening and general aerobic fitness as examples of therapeutic exercise [3].
More on surgery for osteoarthritis
The NHS (the UK’s National Health Service) says surgery for osteoarthritis is only needed in a small number of cases where other treatments haven’t been effective or where your daily life is seriously affected [4]. Surgery cannot be guaranteed to get rid of your symptoms altogether, and you may still experience pain and stiffness from your condition [4].
Do age or other health conditions rule out a referral for joint replacement?
NICE says people with osteoarthritis should not be excluded from referral for joint replacement because of age, sex or gender, smoking, other health conditions, or overweight or obesity, based on measurements such as body mass index (BMI) [3]. If referral for joint replacement is being discussed, NICE says to explain to the person with osteoarthritis that the risks of joint replacement can vary depending on those factors [3]. This is about whether someone can be referred. It is not a promise that surgery will be offered.
When is urgent help needed?
The list below covers the signs that should not wait for a routine appointment.
What should I do next?
If knee pain is not settling, or you are unsure what is causing it, an assessment is a sensible next step. The assessment brings together the patient’s story, an examination and any tests that help, so that the patient and the surgeon can decide together. It looks at the structure involved, the patient as a whole person and the goal they want to return to. An appointment supports an informed decision. It is not a commitment to surgery.
- Read about the Knee Hub.
- Read about the ACL reconstruction surgery.
- Read about the total knee replacement surgery.
- Read about the partial knee replacement surgery.
- Read about knee surgery and non-surgical options.
This page provides general information and cannot diagnose an individual condition. OrthoKinetics does not provide emergency or urgent care through this webpage or its WhatsApp contact.
References
- NICE. Osteoarthritis in over 16s: diagnosis and management (NG226), information for the public. https://www.nice.org.uk/guidance/ng226/informationforpublic (accessed 5 October 2026).
- AAOS OrthoInfo. Anterior Cruciate Ligament (ACL) Injuries. https://www.orthoinfo.org/diseases–conditions/anterior-cruciate-ligament-acl-injuries (accessed 5 October 2026).
- NICE. Osteoarthritis in over 16s: diagnosis and management (NG226), published 19 October 2022. https://www.nice.org.uk/guidance/ng226/resources/osteoarthritis-in-over-16s-diagnosis-andmanagement-pdf-66143839026373 (accessed 5 October 2026).
- NHS. Osteoarthritis: treatment and support. https://www.nhs.uk/conditions/osteoarthritis/treatment/ (accessed 5 October 2026).
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