Understanding When Surgery is Right – Total Joint Surgery

As an orthopaedic surgeon, I see lots of patients in need of total joint replacements. I also see plenty of patients who have joint issues but aren’t ready for surgery yet. Unlike many others in my profession, I’m not one to recommend rushing into surgery at the first sign of pain or inflammation. I believe it’s best to try conservative care methods whenever possible. But, once these stop being effective, it might be time to consider a joint replacement.


Today, I’m going to run through some of the most common reasons for choosing joint replacement surgery. The two surgeries I will be discussing in this article are hip and knee replacements. Since these are both weight-bearing joints, the factors for choosing surgery are similar for both of them.


Living with Joint Pain. While any level of pain is less than ideal, joint pain can often be kept under control without the need for surgery. Here are a few nonsurgical techniques for controlling joint pain.


  • Braces: Supportive joint braces help to take pressure off the joint, which can help with pain. While soft braces are often more comfortable; bulkier, more solid braces provide better support and stability. Knee braces are widely available at most pharmacies, but hip braces can be trickier to find. Talk to you doctor about the best options for you.
  • Footwear: Everything in your body is connected in some way, and there is a direct connection between wearing better shoes and arthritis pain. Supportive shoes with good arch support help take pressure off the knees and hips.
  • NSAIDs: You can control pain and inflammation by regularly taking over-the-counter anti-inflammatory drugs. I recommend taking Advil (one 200 mg tablet every 4-6 hours) or Aleve (one 220 mg tablet every 8-12 hours).
  • Topical medications: For extra comfort, you can add a pain-relieving cream to your conservative care regimen. I recommend Aspercreme with lidocaine, which can be found at your local drugstore.


When to Say When. If you’re looking at this list and thinking, “I’ve tried all of that and more,” it might be time to consider total joint replacement surgery. If you need your brace from the second you get up in the morning until you get in bed at night, let’s talk about surgery. If you have difficulty walking or climbing stairs due to pain, let’s talk about surgery.


My point is that everyone’s joints are different. Everyone’s pain is different. But once you’ve tried everything except surgery, and your joint pain is still greatly affecting your daily activities, don’t suffer forever.


Don’t Rush. Now, if you’re looking at the list above and thinking, “That’s too much work. Just give me the joint replacement,” that’s not an attitude I can agree with. While total joint replacements can be life-changing, they aren’t perfect miracles.


If you get a joint replacement at forty, you could be looking at two additional replacements later on in life. Artificial joints are getting better all the time, but they don’t last forever. In addition, high-impact activities or excess weight can cause artificial joints to wear out even faster.


While this may sound like a “tough it out” mentality, I’m simply trying to make sure that my patients don’t have to endure more surgeries than absolutely necessary. Total joint replacement is a complex surgery with a long recovery time. I don’t want anyone to have to go through it multiple times if they don’t absolutely have to.