When is joint replacement needed?

Joint replacement may be considered when joint damage causes severe pain, stiffness, or loss of movement that significantly affects everyday life. Patients may struggle with walking, stairs, sleep, work, or basic activities even after trying appropriate non-surgical treatment. Osteoarthritis is a common reason for hip and knee replacement, but other forms of arthritis, injury, and bone damage can also lead to surgery.

Before recommending replacement, doctors usually consider treatments such as medicines, physiotherapy, exercise, weight management, walking aids, or injections when suitable. If these options no longer provide enough relief and imaging shows significant joint damage that matches the patient’s symptoms, replacement may become a reasonable option.

The decision is individual. Age alone does not determine whether someone needs surgery. The surgeon also considers general health, activity level, expectations, anaesthetic risk, and the ability to participate in rehabilitation. Joint replacement is generally recommended when the expected improvement in pain and function is greater than the risks of the operation.

A useful sign that replacement may be worth discussing is when the patient begins planning daily life around the joint, such as avoiding stairs, walking only short distances, waking repeatedly at night, or stopping valued activities. Even then, the decision should be shared between the patient and surgeon after discussing expected improvement, surgical risk, implant longevity, and the demands of rehabilitation.