If you live with arthritis, you know the pain and stiffness well. As symptoms build over the years, most of my patients reach the same question: is it time for a joint replacement? There's no single test that answers it, but there are clear signs. Here are the five I discuss most often.
1. The pain is taking over
Pain and swelling are hallmarks of arthritis, whether it's osteoarthritis from wear and tear or an inflammatory arthritis such as rheumatoid arthritis. Ask yourself how much room the pain takes up in your life. Is it getting steadily worse? Is it affecting your mood or your sleep? Are you leaning on pain medication more than you'd like? Those are signs your current treatment isn't going far enough.
2. Everyday activities have become hard
Giving up marathons is disappointing. Struggling to climb stairs, walk the dog or bend down to put on your socks is something else entirely. When arthritis gets in the way of daily life, a joint replacement belongs in the conversation.
3. You've tried the other options
We have many tools for arthritis: anti-inflammatory medication, cortisone or gel injections, braces and canes, physical therapy and weight loss. Not every option suits every patient. Some medications rule out anti-inflammatories, and a bad back can make therapy difficult, so treatment should be tailored to you. But if you've worked through the options that make sense and you're still struggling, you may be a good candidate for surgery. (I cover injections in more detail in a separate article.)
4. You're ready for surgery and recovery
Joint replacement is very effective, but it isn't for everyone. Part of my job is making sure you're healthy enough for an operation. I may ask you to lose weight or stop smoking first. And you'll need to commit to rehabilitation afterward, because the work you put in during recovery shapes how well your new joint performs.
5. You simply feel it's time
For years, patients were told to put off joint replacement as long as possible, and some were told they were too young. Today, the decision has more to do with your symptoms and less to do with your age.
Techniques and implants have improved, and procedures are safer and less invasive than they were. With Mako robotic-arm assisted surgery, I plan every knee replacement on a 3D model of your own joint, and some patients are able to go home the same day.
The real question: quality of life
Ultimately, joint replacement surgery is a question of quality of life. If you're feeling down, missing social events, skipping activities you enjoy or struggling with everyday tasks, it's worth a conversation. Take the two-minute self-check on this site, then bring your answers to a consultation.
- Adapted and updated from Dr. Akhtar's column, “5 Signs It's Time for Joint Replacement Surgery,” Inova Newsroom, May 2018.
This article is for general education and is not medical advice. Talk with your surgeon about your own situation.