Bone on Bone Knee Treatment London — What Are Your Options Without Surgery?
“Bone on bone.” It is one of the most daunting phrases a patient can hear from a clinician. And in our experience at Proback Clinic in Victoria, London, it is also one of the most misunderstood — because what it actually means for your treatment options is far more nuanced than most people are told.
Every week we see patients who have been given this diagnosis and told that knee replacement is now inevitable. Some have been waiting on the list for months. Others have tried steroid injections that worked briefly and then stopped. Almost all of them have been given very little information about what is actually happening in the joint — and even less about what alternatives exist before taking the surgical step.
This post is our attempt to give you the full picture.
What Does Bone on Bone Actually Mean?
Your knee joint is normally cushioned by a layer of cartilage that covers the ends of the femur and tibia. This cartilage allows the joint to move smoothly and absorbs the compressive forces of walking, climbing stairs and everything else you ask your knees to do.
When that cartilage breaks down — through osteoarthritis, injury, age or a combination of all three — the gap between the bones progressively narrows. “Bone on bone” simply means the cartilage has worn away to the point where the bones are in direct contact, or very close to it.
What most clinicians do not always explain clearly is that the degree of bone on bone matters enormously. A knee that shows bone on bone on an X-ray can range from moderate narrowing in one compartment to complete loss of space across the whole joint. These are very different situations with very different prognoses — and treating them identically is one of the reasons so many patients end up frustrated with their outcomes.
The Problem With Steroid Injections for Bone on Bone Knees
If you have been told you have bone on bone arthritis and you have had steroid injections, you have probably noticed a pattern — the first injection helped, the second helped less and by the third or fourth you were barely getting any relief at all.
This is not a coincidence. Steroid injections work by suppressing the inflammatory response within the joint. For a knee that is mildly inflamed this can provide meaningful short term relief. But for a bone on bone joint that is generating pain through a combination of inflammation, structural instability and nerve sensitisation, suppressing the inflammation addresses only one component of a more complex problem.
More significantly, the published evidence on repeated corticosteroid injections in osteoarthritic joints is increasingly concerning. Multiple studies have shown that repeated steroid injections accelerate cartilage breakdown over time — meaning every injection into an already deteriorating joint may be actively making the underlying problem worse. It is a deeply uncomfortable truth that is not always communicated clearly to patients who are simply looking for relief.
What Are the Non-Surgical Options?
At Proback we use a combination of Prolozone therapy and Prolotherapy for bone on bone knee presentations — and we see consistently strong results even in patients who have been told replacement is the only remaining option.
Prolozone involves the injection of medical grade ozone directly into the knee joint. Ozone dramatically improves oxygenation and circulation within the joint space — cartilage has no direct blood supply and relies entirely on the surrounding synovial fluid for its nutrients. By improving that environment we create conditions in which the remaining cartilage and joint tissue can function significantly better. The anti-inflammatory effect of ozone at the joint level is also powerful and sustained in a way that steroid injections simply are not.
Prolotherapy works alongside Prolozone by addressing the structural component. When cartilage breaks down the surrounding ligaments and soft tissue structures are placed under enormous compensatory stress. The joint becomes increasingly unstable and that instability accelerates the degenerative process. Prolotherapy — injected precisely into the damaged ligaments and soft tissue around the knee — stimulates new collagen production and progressively restores the structural support that the knee has lost. As stability improves, the abnormal loading patterns that have been grinding away at what remains of the joint surface are reduced.
The combination of these two approaches addresses both the inflammatory environment and the structural instability simultaneously. This is why we see results in bone on bone presentations that steroid injections alone cannot produce.
What Can We Realistically Achieve?
We want to be completely honest here because we think patients deserve a straight answer rather than an optimistic one.
We cannot regenerate cartilage that has been completely lost. No injection treatment can. What we can do is create a significantly better joint environment — reduce the chronic inflammation, improve the oxygenation and circulation, stabilise the surrounding structures — that translates into meaningful and lasting reduction in pain and improvement in function for most patients.
In our experience across over 10,000 regenerative injection procedures at Proback, bone on bone knee patients who complete a full course of Prolozone and Prolotherapy typically achieve one of three outcomes: meaningful improvement sufficient to delay surgery by years, enough improvement that surgery is no longer felt to be necessary, or — in a smaller proportion of more advanced cases — modest improvement that improves quality of life without eliminating the need for surgery eventually.
We will always tell you honestly at your results appointment which category we think you are likely to fall into based on your specific imaging and clinical picture. We would never encourage someone to pursue a course of treatment if we do not genuinely believe it is going to help them.
How to Get Started
Our initial consultation is on special offer at £110 — reduced from £270 — and includes a full clinical examination, standing X-rays where required and a dedicated results appointment where your findings and a personalised treatment plan with full pricing are presented before you commit to anything further.
Proback Clinic has delivered over 10,000 ultrasound guided regenerative injection procedures and is the official UK training partner of the European School of Prolotherapy. Our practitioners are trained to the highest European standard in regenerative injection therapy.
Give us a call on 0207 976 6648 or email victoria@proback.co.uk. We are based at 4 Evelyn Mansions, Carlisle Place, Victoria, London SW1P 1NH — five minutes from Victoria station.
Frequently Asked Questions
Can bone on bone knee be treated without surgery?
Yes — for many patients Prolozone and Prolotherapy produce meaningful and lasting improvement in pain and function even in bone on bone presentations. We cannot regenerate cartilage that has been completely lost but we can create a significantly better joint environment that reduces pain and improves function — often enough to delay or avoid surgery entirely.
How many sessions are needed for bone on bone knee treatment?
Most bone on bone knee patients require between four and six sessions of Prolozone and Prolotherapy spaced two to four weeks apart. The exact number recommended for your specific presentation is confirmed at your results appointment before you commit to anything.
Is Prolotherapy better than steroid injections for bone on bone knees?
For bone on bone arthritis specifically yes — steroid injections suppress inflammation temporarily but do not address the structural instability or the progressive joint deterioration. Published evidence also shows that repeated steroid injections accelerate cartilage breakdown over time. Prolotherapy and Prolozone address the underlying joint environment rather than suppressing the symptoms.
How much does bone on bone knee treatment cost in London?
Our initial consultation is £110 reduced from £270. Treatment is £275 for one knee per session and £360 for both knees together. A 15% discount applies when prepaying for a full course upfront — or pay as you go session by session.
Can I still have surgery after trying Prolotherapy?
Yes — surgery remains available to you regardless of whether you try regenerative treatment first. Prolotherapy and Prolozone do not affect or complicate surgical outcomes. Trying regenerative treatment first costs nothing in terms of your surgical options.
Where is Proback Clinic located?
We are based at 4 Evelyn Mansions, Carlisle Place, Victoria, London SW1P 1NH — five minutes walk from Victoria station. We welcome patients from across the UK and for those travelling from outside London we can arrange consultation, results and first treatment all on the same day.
Give us a call on 0207 976 6648 or email victoria@proback.co.uk.
