When should I talk to my doctor about knee replacement surgery?

That’s a question you and your orthopedic surgeon will have to answer together. But when knee pain is so bad it actually interferes with the things you want or need to do, the time may be right.

Knee replacement may be an option when nonsurgical interventions such as medication, physical therapy, and the use of a cane or other walking aid no longer help alleviate the pain. Other possible signs include aching in the joint, followed by periods of relative relief; pain after extensive use; loss of mobility; joint stiffness after periods of inactivity or rest; and/or pain that seems to increase in humid weather.

Your primary-care doctor may refer you to an orthopedic surgeon who will help you determine when/if it’s time for knee surgery and which type of knee surgery is most appropriate. Your surgeon may decide that knee replacement surgery is not appropriate if you have an infection, do not have enough bone, or the bone is not strong enough to support an artificial knee.

Doctors generally try to delay total knee replacement for as long as possible in favor of less invasive treatments. With that being said, if you have advanced joint disease, knee replacement may offer the chance for relief from pain and a return to normal activities.

How common are knee replacements?

Knee replacement is a routine surgery performed on more than 600,000 people worldwide each year. More than 90% of people who have had total knee replacement experience an improvement in knee pain and function.¹

How do I get a diagnosis?

To diagnose your condition, an orthopedic surgeon will perform a thorough examination of your knee, analyze X-rays, and conduct physical tests. You will be asked to describe your pain, if you suffer from other joint pain, and if you have endured past injuries that may have affected your current knee condition. It may be helpful to keep a record of your knee pain to share with your doctor. Your knee joints will then be tested for strength and range of motion through a series of activities, which include bending and walking. X-rays of your knee joint will indicate any change in size or shape, or any unusual circumstances.

Signs that it might be time for a knee replacement:

• Your pain persists or recurs over time
• Your knee aches during and after exercise
• You’re no longer as mobile as you’d like to be
• Medication and using a cane aren’t delivering enough relief
• Your knee stiffens up from sitting in a car or a movie theater
• You feel pain in rainy weather
• The pain prevents you from sleeping
• You feel a decrease in knee motion or the degree to which you’re able to bend your knee
• Your knees are stiff or swollen
• You have difficulty walking or climbing stairs
• You have difficulty getting in and out of chairs and bathtubs
• You experience morning stiffness that typically lasts less than 30 minutes (as opposed to stiffness lasting longer than 45 minutes, a sign of an inflammatory condition called rheumatoid arthritis)
• You feel a “grating” of your joint
• You’ve had a previous injury to the anterior cruciate ligament (ACL) of your knee

Reference

1. Consensus Statement on total knee replacement. NIH Consens State Sci Statements. 2003 Dec 8-10;20(1):1-34