How to know when it’s time for a joint replacement

Joint replacement surgeries are some of the most successful and popular operations in the medical field. These procedures have helped countless people achieve more mobility and less pain with brand new hips or knees. Sounds like the perfect solution to joint pain, right? But how do you know if you’re ready for joint replacement surgery?

It’s not a simple answer, and the timing of your surgery can greatly affect your result. An orthopedic surgeon who specializes in these operations can help you decide if and when to have surgery. A surgeon will talk to you about your pain level and mobility, examine how you walk and evaluate your x-rays before recommending a plan.

If you’re experiencing joint pain and thinking about surgery, it will help to be familiar with the following points before you start a conversation with your surgeon:

Arthritis and cartilage

The most common form of arthritis is called osteoarthritis, a degenerative process which causes your cartilage cushion to wear down. Since cartilage covers the bones in your joints, this can affect how your joints move and feel. If your x-rays show that your cartilage cushion around your joints is gone, it may be time for surgery. Patients call this state “bone on bone.” If your x-rays show you still have your own cartilage, it’s probably too soon for replacement surgery.

Hip vs. knee replacement

Deciding on hip replacement can be easier than choosing to have a knee replacement. Here’s why: Hip pain is constant, and non-surgical methods of relieving pain aren’t as effective as with knees.

Knees are more difficult. Knee pain will come and go, so it’s harder to recognize your pain level. Also, there are other effective ways to relieve pain for knees besides surgery. Injections and physical therapy tend to work better for knees compared to hips. Knee replacement patients often don’t expect the pain that comes with rehab after surgery.

Your symptoms: A personal choice

Ice and heating packs, joint injections, weight loss, over-the-counter medications and physical therapy can all help reduce pain. However, if you’ve tried these methods and you still have severe pain in your groin or around your knee, it’s time to see a surgeon. While we can make medically based recommendations, remember that having joint surgery is a personal decision.

My patients often make the choice to have surgery when their pain is so bad they can’t even sleep or it prevents them from traveling or doing something they love. Patients ready for surgery often stop asking what they can’t do with a total joint, and start looking forward to what they can do after surgery.

Still not sure?

If you have daily pain that limits your activities, you may benefit from surgery. Surgeons can certainly guide your decision, but the final choice is yours. We want you to feel a big enough improvement after your surgery to be glad you went through the procedure. And remember, joint replacement surgeries have been helping people for decades and most patients are very happy with their results.

 To learn more about hip and knee arthritis, sign up for our free Hip and Knee Pain 101 class. You’ll learn how to get relief fast and have your questions answered by the doctors at the Center for Joint Replacement at AAMC.


By James MacDonald, MD, orthopedic surgeon at  AAMC Orthopedics. To reach his practice, call 410-268-8862

Originally published July 21, 2016. Last updated on May 18, 2019.

Leave a Reply