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When should I get a knee replacement?

Knee pain can keep you from living your fullest life. But how do you know when it’s time to consider a knee replacement? Board-certified orthopedic surgeon Kevin Fain, MD, gives those suffering from chronic knee pain the need-to-know facts about knee replacement.

What is a knee replacement?

A knee replacement is a surgical procedure used to treat advanced arthritis. In this procedure, the worn surfaces of the knee joint are replaced with artificial surfaces. Some knee replacements replace all of the joint surfaces, and some replace only the worn surfaces of the native knee.

What is arthritis?

Joint cartilage serves as a low-friction gliding surface and "cushions" the knee. Arthritis is the deterioration or destruction of that cartilage. There are several types of arthritis: osteoarthritis, post-traumatic arthritis and inflammatory arthritis (e.g., rheumatoid arthritis, psoriatic arthritis, gout, etc.).

In advanced stages, arthritis can completely wear away the cartilage, causing bone to hit bone. This condition often results in pain, stiffness and disability in the worn joint.

How can arthritis be treated without knee replacement?

In general, arthritis is initially treated with low-impact exercise, anti-inflammatory medications and injections into the knee. There are several types of injections: steroid (aka cortisone, viscolubricants, or cock's comb), protein-rich plasma and stem cells. If the person is overweight, weight loss can be of huge benefit. If a person is bow-legged, a corrective brace can at times be beneficial.

In some patients, particularly younger patients, outpatient arthroscopic surgery can give temporary relief. This type of surgery is minimally invasive and performed through small incisions called “poke-holes.”

Who is a candidate for knee replacement?

In general, knee replacement is considered for patients who have arthritis and continue to have disabling pain, despite nonsurgical treatment. Ideally, the patient would be 50-years-of-age or older, but this is a rough guideline. Many knee replacements are performed in people younger than 50.

Body mass index (BMI) is used by some surgeons when considering knee replacement candidates. Because the complication rates are higher in obese patients, some surgeons will not perform knee replacements for patients with a high BMI.

When is the right time for a knee replacement?

Ultimately, the right time for a knee replacement is an individual decision based on the patient’s pain level, the degree of disability and the desired level of activity. In general, knee replacement should be considered when nonsurgical treatment fails to adequately control the pain, and it is negatively affecting your quality of life.


If you are experiencing chronic knee pain, talk to your doctor about treatment options. To schedule an appointment with Dr. Fain in Athens, call 903-675-9526. For a complete list of UT Health East Texas orthopedic physicians and clinic locations, visit

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