Knee Arthritis Specialist — San Antonio, TX
Bone-on-bone knee pain doesn't automatically mean surgery. Dr. Sean Shahrestani, MD offers a full spectrum of knee arthritis treatments — from hyaluronic acid and PRP injections to robotic total and partial knee replacement — tailored to your lifestyle and goals.
Understanding Your Condition
Knee osteoarthritis — the most common form of knee arthritis — is a degenerative joint disease in which the protective cartilage covering the ends of the bones in the knee gradually wears away. Over time, the bones begin to rub against each other, causing pain, swelling, stiffness, and loss of function.
The knee has three compartments: the medial (inner), lateral (outer), and patellofemoral (kneecap). Arthritis can affect one, two, or all three compartments, and the distribution matters when choosing between partial and total knee replacement.
Knee arthritis is one of the most common causes of disability in adults, affecting millions of Americans. Risk factors include age, obesity, prior knee injuries, family history, and occupations that place repetitive stress on the knee.
The critical thing to know: knee arthritis is highly treatable. Even severe "bone-on-bone" arthritis can often be managed effectively without surgery — and Dr. Shahrestani will always start with the most conservative option that makes sense for your situation.
Quick Facts
Recognizing the Signs
Knee arthritis symptoms often develop gradually. Common warning signs include:
Knee pain that specifically worsens on stairs is a classic symptom of patellofemoral or medial compartment arthritis.
Stiffness and difficulty bending the knee when you wake up — often improving after 20–30 minutes of movement.
Accumulation of fluid in the knee joint (effusion) after activity, causing visible puffiness and a feeling of tightness.
A crunching, grinding, or popping sensation with movement — the sound and feel of bone-on-bone contact.
A feeling that the knee might buckle or give out — particularly on uneven surfaces or when descending stairs.
As medial compartment arthritis progresses, the knee can bow inward (varus deformity), placing increasing stress on the joint.
Non-Surgical Treatment
Before recommending surgery, Dr. Shahrestani evaluates every patient for non-surgical options. The right injection can provide months of significant relief.
Corticosteroids are injected directly into the knee joint to reduce inflammation and pain. Fast-acting and effective for moderate-to-severe flares of knee arthritis.
Viscosupplementation replaces the natural lubricating fluid in the knee joint, reducing bone-on-bone friction. Especially helpful for mild-to-moderate osteoarthritis.
Platelet-rich plasma uses concentrated growth factors from your own blood to reduce inflammation and potentially slow cartilage breakdown in the arthritic knee.
Treatment Approach
Dr. Shahrestani believes that knee replacement is earned — not prescribed at the first sign of arthritis. Here is how he approaches knee care:
Strengthening the quadriceps, hamstrings, and hip muscles reduces load on the knee joint. Weight loss of even 10–15 lbs can significantly reduce knee pain.
Cortisone, hyaluronic acid, and PRP injections to reduce inflammation, lubricate the joint, and delay disease progression — potentially for years.
Unloader braces redistribute weight away from the most arthritic compartment of the knee, providing relief and protecting against further damage.
When conservative care is no longer adequate, robotic knee replacement delivers precisely aligned implants, natural knee feel, and a return to active life.
You don't have to just live with it. Dr. Shahrestani will evaluate your knee, review your imaging, and give you a clear, honest plan — surgical or non-surgical — based on what's actually best for you.
3903 Wiseman Blvd, Suite 213 • San Antonio, TX 78251
Advanced Surgery
When knee arthritis reaches a stage where it significantly limits your daily life and non-surgical treatments are no longer providing adequate relief, knee replacement surgery is one of the most successful and well-studied procedures in orthopedics — with over 90% of patients reporting long-term satisfaction.
Dr. Shahrestani specializes in robotic-assisted knee replacement, which uses pre-operative CT-based planning and real-time robotic guidance to place implants with greater accuracy than traditional techniques. The result: better limb alignment, more natural knee feel, reduced risk of early loosening, and faster functional recovery.
For patients with arthritis affecting only one compartment of the knee, Dr. Shahrestani also performs partial (unicompartmental) knee replacement — a less invasive procedure that preserves healthy bone and ligaments, offers faster recovery, and results in a more natural-feeling knee than total replacement.
The right choice — partial or total — depends on your X-rays, anatomy, activity level, and goals. Dr. Shahrestani will walk you through both options clearly and honestly before any decision is made.
Partial vs. Total Knee Replacement
What Patients Say
"Dr. Shahrestani has replaced both of my knees. After finishing therapy, I am now able to walk without pain. He is very straightforward about what is involved with the procedure, making sure that you understand the risks involved."
"Dr. Shahrestani has been a game-changer in my life. He demonstrates a genuine commitment to improving his patients' lives. He provides you with all the facts and addresses all questions. I highly recommend Dr. Shahrestani to anyone seeking an exceptional Orthopedic Specialist."
"If you need anything done as far as hip replacement or knee, he is the man! Great doctor, I would recommend him over any doctor. Try him out — I promise you won't regret it."
Average rating across Google & Healthgrades — from real patients who trusted Dr. Shahrestani with their joint care.
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Tired of living around your knee pain? Call Dr. Shahrestani's office today — same-week appointments available.
📞 Call 210-680-1000