For generations, the worn knee has led almost inevitably to the operating table — a path accepted as necessary even as it carried real costs in risk, recovery, and permanence. Now, researchers are developing treatments that would intervene earlier, working with the body's remaining capacity rather than replacing what has been lost. The promise is not merely medical but systemic: fewer surgeries could mean lighter burdens on patients, hospitals, and the broader architecture of care. Whether this shift becomes standard practice depends on the evidence still being gathered, but the direction of i