Published: February 13, 2025 | Updated: February 18, 2025
Estimated reading time: 4 minutes
If you’ve been having trouble getting around on arthritic knees, you may be wondering if you need knee replacement surgery. When considering joint replacement surgery, there are a few ways you can determine whether you’re ready to discuss it with your orthopedic provider.
Kevin J. Himschoot, M.D., orthopedic surgeon with Norton Orthopedic Institute, suggests thinking about the following:
Does your pain come and go? Does it occur only during strenuous activity? Or is it persistent knee pain that interferes with daily life?
If your pain comes and goes, you’re likely not ready for surgery. The good news: There are some nonsurgical ways to get pain relief. These may include taking nonsteroidal anti-inflammatory drugs (NSAIDs) or steroid injections for pain relief. Physical therapy exercises and stretches can improve strength and mobility by loosening muscles, ligaments or the knee joint capsule — ligaments and fibers that surround the joint.
Read more: Don’t ignore these 5 symptoms of joint pain
Next, think about your age and activity level. If you are active and would like to stay active for many years to come, a knee replacement may make that possible. Surgeons are performing joint replacement surgery on younger patients than they have in the past. However, surgery typically will not be considered until you are in your 50s. Also, unless X-rays show moderate to advanced knee arthritis, nonsurgical treatment will be recommended.
Finally, how is the rest of your health, including your weight? Carrying extra weight is a big factor in knee pain, as the knee has significant weight-bearing responsibilities. Surgeons typically will not perform knee replacement surgery on patients with a body mass index over 40, as it increases complications during and after surgery.
There are, however, physical therapy programs tailored to help with weight loss while supporting and aiming to improve chronic knee pain. Your health care provider can help you find a physical therapy or weight loss program to suit your needs.
Do you have heart disease or diabetes? Is your diabetes under control with an appropriate hemoglobin A1C level? Optimizing chronic medical conditions will be necessary prior to surgery.
You’ll also want to make sure you’re mentally prepared for a tough couple of weeks after surgery.
Can you push through pain during physical therapy as you work on strengthening and moving your new joint?
If you have extensive knee joint damage due to conditions such as osteoarthritis or rheumatoid arthritis, you may be a candidate for a total knee replacement. In this procedure, known formally as total knee arthroplasty, all three compartments of the knee joint are replaced with artificial components.
A partial knee replacement replaces only the damaged compartment of the knee (either the medial, lateral or patellofemoral compartment). This is considered in cases where the arthritis is confined to just one area of the knee and the ligaments are intact. This less-invasive option often results in quicker recovery times and more natural knee movement for suitable candidates.
Whether you’re having total knee replacement surgery or having just one side of the knee replaced, the ends of the thigh bone and shin bone are replaced with artificial components. Sometimes, the kneecap or patella is replaced as well.
Advancements in robotics help your surgeon improve precision, which can reduce recovery time and give you a more natural-feeling knee.