Alternatives to Knee Surgery for an Unstable Knee

Side-by-side: braces vs. cortisone injections

Here's how the most common non-surgical options compare on cost, fit, and what they actually do for an unstable knee.

1. Strengthening and balance training

The thigh and hip muscles are the knee's active stabilizers. Building the quadriceps, hamstrings, and hip muscles, and retraining balance and control on one leg, is the foundation of nearly every non-surgical plan and helps many people feel noticeably more stable.

A physical therapist can match the program to the cause (a torn ligament, arthritis, or weakness after surgery) and progress it safely. Expect to work at it consistently for several weeks before judging the results.

2. Changing how you load the knee

Cutting back on pivoting, twisting, and jumping, the motions that most often make an unstable knee give way, gives the rest of your plan a chance to work. For people with arthritis, losing excess weight reduces the load on the knee with every step.

3. Knee bracing

A brace adds external support that limits the motions your knee can't control on its own, such as shifting side to side or twisting. It works immediately, doesn't wear off, and can be worn during the activities where your knee is least reliable. It doesn't repair a ligament, and it works best alongside strengthening.

• Sleeves and wraps: compression and warmth, but little mechanical support for real instability.
• Off-the-shelf hinged braces: side hinges in standard sizes; they help some people but often slide down or fit poorly.
• Off-the-shelf functional and unloader braces: more rigid designs for ligament instability or arthritis, commonly around $400 to $900.
• Custom-fabricated braces: built from your leg's measurements, cast, or scan for the closest fit. From the major brace makers these commonly sell for about $500 to $1,500 or more, usually after an in-person measuring or casting visit.

4. Cortisone (corticosteroid) injections

A cortisone shot delivers an anti-inflammatory steroid into the knee joint. For an arthritic knee that's swollen and painful, it can provide fast relief, typically lasting a few weeks. Your physician decides whether it's appropriate and how often it can be repeated.

Cortisone doesn't make a knee more stable. It doesn't tighten stretched or torn ligaments, and any sense of steadiness usually comes from having less pain. Repeated injections also carry tradeoffs: in a two-year randomized trial published in JAMA, knees injected with cortisone every 12 weeks lost more cartilage than knees injected with saline, with no difference in pain. That's one reason clinicians limit how often they're given.

Other injections, including hyaluronic acid ("gel") and platelet-rich plasma (PRP), are sometimes offered for arthritic knees. Evidence for them is mixed, and like cortisone, they target pain rather than instability.

5. Medications

Anti-inflammatory pills or creams can reduce pain enough to make exercise easier. Ask your physician or pharmacist which are safe for you, especially if you take other medications or have stomach, kidney, or heart conditions.

Putting it together

The approaches work best in combination: strengthening to build the knee's own stability, a brace to protect it during the activities that cause giving way, and, for arthritic knees, injections or medication to control pain flares along the way.

Consider a surgical opinion if the knee keeps giving way despite a good trial of these, if it locks and won't straighten, or if you're young and active with a torn ACL and want to return to pivoting sports.

Why BISHOP is the value leader

Custom-fabricated braces fit best, but their cost and the fitting visits they require put them out of reach for many people. BISHOP set out to change that.

• $299.99 per knee plus shipping, compared with the roughly $500 to $1,500 or more that custom braces from the major makers commonly cost.
• One purchase instead of repeat bills: less than the typical billed charge for about one year of cortisone shots, and it keeps working every day you wear it.
• No fitting appointment: you scan your leg at home with any iPhone that has Face ID, and your brace ships 1 to 4 days after payment.
• A 3-year warranty, and a fit guarantee: if it doesn't feel right, we'll troubleshoot the fit with you on a call, and you can return it within 30 days of delivery for the cost of return shipping.
• Covered after the warranty, too: the optional Reprint Plan ($5 per month per brace) gets you one free reprint every 3 years once the warranty ends, for the cost of shipping.
• Designed by a physical therapist, 3D-printed, and finished by hand in Shreveport, Louisiana.
• Built from your scan to contact your leg evenly, which helps it stay in place instead of sliding down.

Common questions

Is a brace or a cortisone shot better for an unstable knee?

They do different jobs. A brace supports the knee mechanically and limits the motions that make it give way. A cortisone shot reduces pain and inflammation, mainly in arthritic knees, but doesn't make the knee more stable. Many people use a brace along with strengthening, and some also use injections for arthritis flares.

How long does a cortisone shot in the knee last?

Relief commonly lasts a few weeks, though it varies from person to person. It's a short-term tool, and physicians generally limit how often it's repeated.

What if my BISHOP brace doesn't fit right?

Contact us and we'll schedule a call to troubleshoot the fit with you. If you're still not happy, you can return it within 30 days of delivery; you just pay return shipping. Every brace also has a 3-year warranty.

What happens when my brace wears out?

For the first 3 years, the warranty covers defects. After that, members of the optional Reprint Plan ($5 per month per brace) get one free reprint every 3 years while the plan is active; they just pay shipping.

Why does a BISHOP custom brace cost less than other custom braces?

You capture the scan at home with your phone instead of paying for a casting or measuring visit, and each brace is designed, 3D-printed, and finished in-house in Shreveport and sold directly to you.

Sources

• McAlindon TE, et al. Intra-articular triamcinolone vs saline on knee cartilage volume and pain. JAMA. 2017;317(19):1967-1975
• Efficacy of intra-articular injections for the treatment of osteoarthritis: a narrative review (2025)
• DME-Direct: Custom knee brace pricing (major manufacturers)
• AAOS OrthoInfo: Arthritis of the Knee
• CMS 2026 Physician Fee Schedule, CPT 20610 (national non-facility rate $68.81)
• CMS Part B drug payment limit, J3301 triamcinolone 10 mg (Q3 2026)
• CPT 20610 average provider charge vs. Medicare rate
• CostHelper: Cost of a knee brace