How Do You Know If You Need a Knee Replacement?
Wondering how to know if you need a knee replacement? Learn when to consider one and when conservative treatments may be a better option.
Table of Contents
Deciding to undergo surgery is a significant step, and many people wonder, 'How do you know if you need a knee replacement?' Your choice to move forward with total knee replacement (TKR) surgery should take into account all the factors that contribute to your knee pain and overall quality of life. We understand there’s a lot to consider. That’s why this resource from Hinge Health provides evidence-based guidance to help you make an informed decision.
Our Hinge Health Experts
Christynne Helfrich, PT, DPT
When You May Want to Delay a Knee Replacement
Deciding whether to proceed with a total knee replacement is a big decision, and it’s important to explore all your options before committing to surgery. In some cases, there are non-surgical strategies that may help manage pain, improve function, and delay the need for a TKR. Here are a few situations where it might make sense to hold off.
Conservative treatments haven’t been fully explored. Before committing to surgery, it’s important to ensure that you’ve given conservative treatments enough time to work. These options often require consistency and patience to see meaningful results. Examples include:
Exercise therapy. Targeted exercises help strengthen the muscles around your knee, improve mobility, and enhance overall joint stability. A strong knee can better support your activities and may reduce pain over time.
Pain management techniques. Simple at-home remedies like applying ice to reduce swelling or using heat to relax stiff muscles can help manage discomfort. Medications (if recommended by your doctor) can also play a role in controlling pain while you explore other treatments.
Activity modifications. Small adjustments, such as avoiding repetitive high-impact activities, pacing yourself during daily tasks, or switching to low-impact exercises like swimming or cycling, can help reduce strain on your knee.
Your pain is manageable most of the time. If your pain levels don’t significantly interfere with your daily life, it might be possible to delay surgery. For instance, if pain medications or other treatments help you stay active and perform tasks like walking, climbing stairs, or working without significant discomfort, you may find that surgery is not immediately necessary.
You have factors within your control to address. Knee pain is often influenced by factors such as body weight, physical activity, and diet. Making changes in these areas can sometimes reduce pain and delay the need for surgery.
Weight management. Weight is not always an accurate indicator of health. But carrying extra weight can increase pressure on your knees, which can exacerbate pain. Even a little weight loss — if appropriate and necessary — may make a noticeable difference in how your knees feel.
Diet changes. A balanced diet rich in anti-inflammatory foods (like fruits, vegetables, and omega-3 fatty acids) can support overall joint health.
Increasing physical activity. Regular movement helps maintain joint mobility and reduces stiffness. Low-impact exercises, such as walking, water aerobics, or yoga, are excellent options to stay active without straining your knees.
When It May Be Time for a Knee Replacement
When knee pain and mobility issues start to severely impact your daily life, it may be time to consider a total knee replacement. If non-surgical treatments are no longer effective and pain or stiffness is interfering with basic tasks or your quality of life, surgery could offer a path to lasting relief and improved function. Here are some signs that it might be time to take the next step.
Conservative treatments are no longer effective. If you’ve given treatments like exercise therapy, lifestyle changes, and medications enough time but haven’t experienced significant improvements in your symptoms or daily function, it may be time to consider surgery. Conservative treatments can sometimes plateau in their effectiveness, especially if the damage to your knee joint is severe or progressive.
Other treatments have stopped working. Non-surgical interventions, like cortisone injections, viscosupplementation (hyaluronic acid injections), or physical therapy, can sometimes provide relief. However, if these treatments no longer reduce your pain or improve your mobility, it may indicate that the underlying damage has reached a point where surgery is the next step.
You struggle with daily tasks. If pain or mobility issues are limiting your ability to care for yourself or enjoy basic activities, a TKR may help restore some independence and quality of life. Severe pain and limited mobility can make it difficult to perform even the simplest activities, such as:
Walking short distances (e.g., around your home or to the mailbox) without stopping due to discomfort.
Getting in and out of a chair, bed, or car, as these motions often require bending your knee and bearing weight on it.
Climbing stairs, which can put extra strain on your knees.
Moving around your home without assistance, such as needing a cane or walker to maintain stability or reduce weight-bearing on your affected leg.
Your pain is severe and persistent. Constant, unrelenting pain that doesn’t improve with rest, medication, or other treatments can take a serious toll on your mental and physical health. It can affect your sleep, mood, and ability to focus, which can further impact your overall quality of life. If the pain is interfering with your ability to work, socialize, or simply enjoy life, surgery may provide the relief you need.
Physical therapy (PT) is for more than just recovering from surgery or injury. It’s one of the top treatments for joint and muscle pain. It helps build strength, improve mobility, and reduce pain. And it doesn't always need to be in person.
Hinge Health members can conveniently access customized plans or chat with their care team at home or on the go — and experience an average 68% reduction in pain* within the first 12 weeks of their program. Learn more*.
What to Consider Before Surgery
While total knee replacements often have very successful outcomes, it’s important to remember that surgery is a significant undertaking. Recovery can be long and challenging, and conservative treatment is generally recommended before taking this step.
Ask yourself:
What activities trigger my knee pain?
Are there adjustments I can make to reduce flare-ups or discomfort?
Have I fully explored all non-surgical options to improve my pain and mobility?
If you’re unsure about the next step, talk to your physician or a physical therapist. They can help answer common questions, such as how do you know if you need a knee replacement, based on your individual situation. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit. It’s normal to feel uncertain, and having the right guidance can make all the difference.
Whether you decide to delay or move forward with a total knee replacement, staying consistent with exercise therapy is key. Research shows that patients who engage in pre-surgery exercise therapy recover faster and experience better long-term outcomes.
How Hinge Health Can Help You
If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.
The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.
Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.
See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.
This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
Looking for pain relief? Check if your employer or health plan covers our program
References
Evans, J. T., Walker, R. W., Evans, J. P., Blom, A. W., Sayers, A., & Whitehouse, M. R. (2019). How long does a knee replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. The Lancet, 393(10172), 655–663. doi:10.1016/s0140-6736(18)32531-5
Gränicher, P., Stöggl, T., Fucentese, S. F., Adelsberger, R., & Swanenburg, J. (2020). Preoperative exercise in patients undergoing total knee arthroplasty: a pilot randomized controlled trial. Archives of Physiotherapy, 10(1). doi:10.1186/s40945-020-00085-9
Sharma, R., Ardebili, M. A., & Abdulla, I. N. (2019, January). Does rehabilitation before total knee arthroplasty benefit postoperative recovery? A systematic review. Indian journal of orthopaedics. Retrieved September 23, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6394179/.
Gränicher, P., Stöggl, T., Fucentese, S., Adelsberger, R., & Swanenburg, J. (2020, August 5). Preoperative exercise in patients undergoing total knee arthroplasty: A pilot randomized controlled trial. Archives of physiotherapy. Retrieved September 23, 2021, from https://pubmed.ncbi.nlm.nih.gov/32774889/.