Deciding to have knee or hip replacement

When you are thinking of having knee or hip replacement surgery, you may want to

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and talk to others with knee or hip problems. But a key step is sitting down with your doctor to discuss your quality of life and what your goals are.

Surgery may or may not be the right choice for you. Only careful discussion and thought can help you make a decision.

Who Benefits from Knee Replacement Surgery?

The most common reason to have a knee joint replaced is to provide relief for severe arthritis pain that limits what a person is able to do. Your doctor may recommend knee replacement when:

  • You are having symptoms of knee arthritis, such as:
    • You can't sleep through the night because of knee pain.
    • Your knee pain limits or keeps you from being able to do your normal activities, such as bathing, preparing meals, household chores, and other things.
  • Your knee pain has not improved with other treatment.
  • You understand that surgery and recovery afterwards will be like.

Some people are more willing to accept the limits their knee pain has placed on them. This means waiting until the pain is waking them up at night or preventing them from doing everyday activities.

Others may be interested in knee replacement surgery if their pain is preventing them from taking longer walks, playing tennis or golf, or being able to do other important, casual activities.

Knee or hip replacements are usually done in people age 60 and older. When a knee or hip replacement is done, the new joint may wear out over time. This is more likely to occur in people with a more active lifestyle or in those who will likely live longer. Unfortunately, if a second joint replacement is needed in the future, it may not work as well as the first one.

Is There Any Harm in Waiting?

For the most part, knee and hip replacement are elective procedures. This means the surgery is done to provide relief for your pain, not for any other medical reason.

The good news is that delaying surgery should not make joint replacement surgery less effective if you ever choose to have it. You are in control of this decision and will have the last word.

That being said, if the pain is so severe that you’re hardly getting up and moving around, the muscles around your knee or hip may become weaker, and the bones may become thinner. When this happens, recovering from surgery may be more difficult and take longer.

Reasons You May Not Be Able to Have Replacement

Some medical problems may lead your doctor to recommend that you NOT have knee replacement surgery:

  • Morbid obesity (weighing over 300 pounds)
  • The muscles in the front of your thigh, or your quadriceps, are very weak. Weak quadriceps could make it very hard for you to walk and use your knee.
  • Unhealthy skin around your knee
  • Previous infection of your knee
  • Heart or lung problems make major surgery more risky.

Update Date: 8/12/2011

Updated by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, and Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.


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