October 01, 2020

Is there a "right time" to have my arthritic knee replaced?

Q: Friends have suggested that I think about a knee replacement because I'm frequently in pain on our walks, but that sounds extreme to me. Is there a "right time" to get it replaced?

A: In some ways, yes, there is. A recent study found that it's common to mistime the procedure — getting it earlier than needed or waiting longer than necessary. But defining the sweet spot for knee replacement, when its benefits will outweigh any disadvantages, is highly dependent on each person's situation.

The best advice is to speak with your doctor as soon as you feel signs and symptoms of osteoarthritis. Pain is the key symptom of knee osteoarthritis, though it may also cause the knee to catch or lock — or make creaking or grinding noises — with movement. Vigorous activity tends to cause symptoms to flare, and pain may also be worse when you try to move after sitting or resting. Walking, climbing stairs or getting out of a chair may become increasingly painful. Eventually, you may feel moderate to severe pain even at rest or when sleeping.

Pain that prevents simple daily activities is by far the leading reason people get knee replacement. However, there may be a period of time when nonsurgical management — such as activity modification, losing weight, strengthening exercises, pain medication, corticosteroid injections, use of a brace and other steps — can improve symptoms enough to keep you comfortable doing what you want to do. In these cases, you may be better off delaying surgery.

When osteoarthritis symptoms substantially interfere with comfortable enjoyment of life, knee replacement is an important consideration. Putting off knee replacement too long can result in problems such as decreased mobility — which can limit...