October 22, 2025
Joint pain is no picnic. It can keep you from doing the things you love and leave you feeling like your body is failing you. Let’s face it … when your knees or hips hurt, everything is harder.
But how do you know when it's finally the right time for a knee or hip replacement?
Have it done too early (i.e., with minimal symptoms and X-ray changes), and your new joint may not last your lifetime. You also might not get the same pain relief as you would with severe symptoms. Wait too long, and the joint reconstruction and recovery can become more challenging and demanding on your body — not to mention, you may spend that downtime in pain.
It's not a decision to take lightly, says Elie Ghanem, MD, an MU Health Care orthopaedic surgeon. "Hip and knee replacement surgery is safe and effective, but you never want to just jump into surgery," he says. "The truth is, of the people who come to us for hip and knee pain and arthritis, only about one out of every four or five ends up needing surgery."
Your doctor can certainly provide critical information to help guide your decision. But Dr. Ghanem also suggests spending some time thinking about the questions below to determine whether now is the time for joint replacement surgery:
1. How Severe Is Your Joint Pain?
Evaluating your pain — and its effect on your daily life — is a good place to start when deciding whether it's time for surgery. Things to consider include:
- Ability to perform daily activities: Can you do everyday tasks, such as climbing stairs, taking out the trash and standing at the sink to wash dishes?
- Physical activity: Can you still be active — even if it's not to the extent it once was?
- Sleep: Is the pain keeping you from sleeping through the night?
"Patients who undergo surgery typically have serious physical changes to the joint and severe symptoms that are not controlled with nonsurgical measures," Dr. Ghanem says. "If your symptoms are mild and imaging doesn’t show many visible changes, surgery may not be your best option."
If you’re still not sure, you can always work with the care team.
“We use outcomes questionnaires that patients fill out to help gauge how severe the symptoms are so we can help the patients come to a shared decision-making process,” explains Dr. Ghanem.
2. Have You Exhausted Nonsurgical Treatments for Your Joint Pain?
Nonsurgical treatment can help you feel better, extend the life of your joint and delay the need for surgery. In some cases, it might be enough to avoid the need for joint replacement.
There are several nonsurgical treatment options for joint pain, including:
- Anti-inflammatory medication to relieve swelling and inflammation
- Physical therapy, to strengthen the muscles around the hip and knee to reduce stress on those joints
- Cortisone injections, which can relieve inflammation and pain for three to four months — even longer for some people
- Gel injections, which lubricate the joint to help with movement and reduce pain
- Platelet-rich plasma (PRP) injections, which use a modified version of your own blood to relieve joint pain
- Low-dose radiation, which is a new approach that focuses radiation on the joint to calm inflammation
- Genicular artery embolization (GAE), which is a novel, evidence-based treatment that involves decreasing blood flow to the area to reduce pain and inflammation
"Sometimes, a combination of injections and physical therapy may be all you need," Dr. Ghanem says. "Even when the X-rays look bad, many patients find that once those strengthened muscles remove the stress from their joint, they don't need a replacement."
3. What Is Your Age?
We know, we know … it’s not polite to ask people about their age. But age can play a critical role when deciding whether to have joint replacement surgery.
“Having the surgery earlier in life increases the risk of needing another replacement,” Dr. Ghanem says. “However, the older you get, the more medical issues you may develop. You don’t want to become such a high risk from a medical standpoint that surgery is not a safe option anymore.”
Joint implants, which are primarily made of metal, plastic, and ceramic, have a lifespan of 20 to 25 years. Dr. Ghanem says that based on current literature, about 60% of people will need their joint redone because the implant gets worn out.
4. How Is Your Health?
Surgery stresses the body, so the healthier you are going into it, the better. Your medical history, co-existing conditions (comorbidities) and overall health affect your risk of surgical complications. They also affect how well you recover and how long that recovery takes.
“Patients with serious conditions, such as those affecting the heart, lungs or kidneys, are considered high-risk for any surgery,” Dr. Ghanem says. “If your health is fragile, joint-replacement surgery and recovery are likely not a good option. You may want to pursue the many nonsurgical options we have available instead.”
5. Do You Have the Support You’ll Need for Recovery From Joint Replacement Surgery?
Everyone recovers from surgery differently, but most people need support from others — at least for a time. Recovery from knee replacement surgery takes two to three months. Hip replacement recovery is about six weeks.
“While you recover from joint replacement surgery, you may need rides to appointments and someone to help you at home,” Dr. Ghanem says. “Coordination with friends or family members and having resources in place are critical to recovery.”
6. Is Now a Good Time — Logistically and Financially — to Have Surgery?
Joint replacement surgery can be expensive, and the recovery takes time. The timing of the surgery can affect how stressful your overall experience is.
Research your insurance coverage, consider your work schedule and check your calendar for upcoming events and vacations. Dr. Ghanem also recommends planning with family and friends, so you can be sure they’re also available for physical, mental and emotional support.
“We get busy during certain months of the year, mostly related to holidays and financial and insurance reasons,” Dr. Ghanem says. “But it’s really a personal preference and our team is here to prepare you for what to expect before and after surgery, regardless of the timing you choose.”
7. What Does Your Doctor Say?
Your doctor can’t make the decision to have surgery for you. You have to make the ultimate call. But orthopaedic surgeons manage joint replacement in many, many patients. They can evaluate your overall health, pain level and the state of your joint to provide some insight about timing and treatment options.
“Work with your doctor to decide whether surgery is right and when to have it,” Dr. Ghanem says. “If you do decide to have joint replacement surgery, rest assured that it is a good procedure with excellent outcomes. It’s been tested for more than 50 years.”
Next Steps and Useful Resources
- Want to discuss your options more? Speak with an orthopaedic doctor.
