Hip osteoarthritis treatment before replacement surgeryUK clinical guidance requires documented completion of conservative care — physiotherapy, weight management, analgesia — before accepting a total hip replacement referral. Surgical timing is determined by functional impact, not imaging severity.UK clinical guidance requires documented completion of conservative care — physiotherapy, weight management, analgesia — before accepting a total hip replacement referral. Surgical timing is determined by functional impact, not imaging severity.
ChondroFiller injection vs surgery for focal knee cartilageAn ultrasound-guided collagen injection activates the joint's own regenerative cells to repair focal knee cartilage defects; 70–85% of treated patients report meaningful symptom relief within three to five years.An ultrasound-guided collagen injection activates the joint's own regenerative cells to repair focal knee cartilage defects; 70–85% of treated patients report meaningful symptom relief within three to five years.
Physio or Surgery for Supraspinatus TendinopathySupraspinatus tendinopathy is cellular degeneration, not inflammation: the tendon needs progressive loading to remodel, not rest. Physiotherapy succeeds for most; night pain disrupting sleep or arm weakness indicate when surgical assessment becomes necessary.Supraspinatus tendinopathy is cellular degeneration, not inflammation: the tendon needs progressive loading to remodel, not rest. Physiotherapy succeeds for most; night pain disrupting sleep or arm weakness indicate when surgical assessment becomes necessary.
OATS or OCA for knee cartilage repairrepairs, but prior failedsurgeryor subchondral bone lossrepairs, but prior failed surgery or subchondral bone loss
Who to see first for back pain and sciaticaUp to 90% of sciatica cases resolve withoutsurgerywithin weeks to months, and the evidence points to starting with physiotherapy, not a pain consultant or surgeon.Up to 90% of sciatica cases resolve without surgery within weeks to months, and the evidence points to starting with physiotherapy, not a pain consultant or surgeon.
Physiotherapist or surgeon first for a meniscus tearFor most meniscus tears, physiotherapy is the evidence-supported first step;surgeryis reserved for locked knees, persistent instability, or severe acute injuries that fail to settle.For most meniscus tears, physiotherapy is the evidence-supported first step; surgery is reserved for locked knees, persistent instability, or severe acute injuries that fail to settle.
Who treats rotator cuff tears on the NHSRotator cuffsurgeryis done by aRotator cuff surgery is done by a
Which specialist to see first for sudden wrist painThe right specialist for wrist pain depends on symptom type: inflammatory symptoms point to rheumatology, mechanical symptoms to orthopaedicsurgery, overuse symptoms to physiotherapy.The right specialist for wrist pain depends on symptom type: inflammatory symptoms point to rheumatology, mechanical symptoms to orthopaedic surgery, overuse symptoms to physiotherapy.
Which specialist to see for a meniscus teartears, recent evidence showssurgeryoffers no advantage overtears, recent evidence shows surgery offers no advantage over
Single-stage or two-stage cartilage repair1.5–2 cm² suit single-stagesurgery, those of 2–4 cm²1.5–2 cm² suit single-stage surgery, those of 2–4 cm²
When Knee Alignment Must Come Before Cartilage Repairexpert guidance mandates combinedsurgeryabove 3° varus andexpert guidance mandates combined surgery above 3° varus and
Who treats shoulder impingement syndrome in the UKthrough corticosteroid injections, thensurgeryonly for those unresponsivethrough corticosteroid injections, then surgery only for those unresponsive