Do You Really “Need” a Joint Replacement? Why It’s More of a Choice Than You May Think

Hip and knee pain becomes more common with age, and some people may have been told that they “need” to have a joint replacement.

What Is Joint Replacement Surgery?

Joint replacement surgery removes the worn surfaces of the hip or knee and replaces them with smooth artificial implants, which can relieve pain and restore movement. It works well for many patients and can be life changing. The word “need,” however, can be misleading.

Need or Want?

A hip or knee replacement is almost always planned well in advance, not urgent. For most patients there is rarely a fixed point at which the operation becomes “mandatory.” Whether to proceed, and when, is largely your decision, provided that a worn joint surface is confirmed as the source of the pain. That determination is one to make together with your own surgeon.

For patients with arthritis, the decision generally becomes relevant when the joint begins to limit everyday life. Examples include giving up walks that were once enjoyable or arranging the day around how far one is able to walk comfortably. When this has continued for some time and simpler treatments are no longer providing relief, it is reasonable to consult an orthopaedic surgeon to review the options. If you want a clearer sense of where you stand, it can help to read through the common signs that point toward a hip replacement or a knee replacement.

What Causes Joint Pain?

The damage responsible for joint pain can also have more than one cause. Osteoarthritis, the gradual wearing of the smooth surface within the joint, is the most common reason, but it is not the only one. Inflammatory forms of arthritis, a loss of blood supply to the bone, and the long-term effects of a previous injury can all produce similar joint damage.

A number of nonsurgical measures are usually tried before surgery is considered, and most of them require sustained effort. Staying active in ways that do not aggravate the joint, physical therapy, strengthening, maintaining a healthy weight, anti-inflammatory medication, and in some cases an injection may all provide relief, and together they often add years of comfort. None of these measures work immediately though, and none of them “cure” arthritis. Which options are appropriate is best determined with your own surgeon or physician.

Enough Time to Decide

Because the timing is generally flexible, patients usually have as much time as they need to decide. In many cases a period of waiting does not compromise the eventual result, which allows time to give these measures a fair trial, although whether this applies to your particular situation should be confirmed with your surgeon.

Choosing to proceed with surgery is an equally reasonable decision. When the joint interferes with walking, travel, gardening, or spending time with grandchildren, and simpler measures are no longer enough, the wish to return to your usual activities is a legitimate reason to move forward. There is no requirement to wait until the joint has become severely disabling.

Whether and when to undergo a hip or knee replacement is a decision to make on your own timeline and in consultation with your surgeon, once the options are clearly understood.

Read one experience in Diary of a Total Knee Replacement .

Let’s Have a Conversation:

Have you been diagnosed with arthritis? Which joints are suffering the most? What non-invasive measures have you tried for the pain? What would make you choose surgery?