Whether arthritis aches have been flaring up more often or you’re finding it harder to simply climb the stairs, age-related joint pain can sneak up on millions of Americans. Because it’s so common, many of us normalize living with it and try to manage symptoms on our own without considering medical treatment such as surgery. In fact, Northwestern Medicine reports that 90 percent of people living with osteoarthritis, a form of arthritis that affects the joints, wait too long to undergo knee replacement surgery. The reasons vary. Some worry about cost, others feel anxious about the procedure and many assume their pain simply isn’t severe enough yet.
But what’s often overlooked is how difficult it can be to recognize when it’s truly time to consider a total or partial knee replacement. To help, we spoke with a surgeon about three key questions to ask yourself when deciding whether surgery is right for you. Plus, discover expert-backed tips to manage knee pain in the meantime.
What causes knee pain?
Most often, the leading cause of knee pain as we age is a common condition: osteoarthritis, confirms James B. Chen, MD, a fellowship-trained Orthopedic Surgeon specializing in hip and knee total joint replacement.
“Arthritis is the loss of [joint-cushioning] cartilage that can result in inflammatory pain from the rough surface in the joint and instability from ligament laxity,” explains Dr. Chen. Aside from arthritis, knee pain can be linked to nerve issues, muscle tears, sprains or damage to the meniscus, which is cartilage in the knee joint.
What is knee replacement surgery?
Dr. Chen says nonoperative treatments for knee pain include medications, physical therapy, activity modifications and injections. But if those approaches stop providing relief, knee replacement surgery—where your doctor replaces the damaged joint with an implant made of materials such as metal or plastic—may be the next step.
“A knee ‘replacement’ is really a resurfacing,” explains Dr. Chen. “We are creating a new, smooth surface for the joint to glide on while fixing the components to allow for long-term fixation [secure attachment of the implant to the bone]. This resurfacing typically resolves the inflammation from bone-on-bone arthritis in addition to improving the knee joint’s stability by restoring its normal position.” As a result, normal ligament function is restored.
A partial knee replacement involves replacing only the damaged section of the joint, while a total knee replacement targets all three main areas—the inner side, outer side and front of the knee joint.
How much does knee replacement surgery cost?
“As a baseline, Medicare can be used as an estimate,” says Dr. Chen. “Medicare has a price lookup tool, so patients can see the breakdown of cost for the surgeon and facility. A knee replacement may cost between $9,000 to $13,000. Private insurance mostly covers total knee replacement.”
However, Dr. Chen says cost will ultimately vary depending on where you live, the type of insurance you have and what facility you go to.
Knee replacement recovery time
“The brochure answer [for surgery recovery time] is the knee is stable the same day, patients go home the same day and are walking within an hour after the surgery with minimal pain,” explains Dr. Chen.
However, Dr. Chen adds that knee replacement surgery is highly personal and depends on a patient’s strength before the operation, overall health, the type of implant used and the goals you and your surgeon are working toward.
3 questions to help determine if you need knee surgery
First, you’ll want to know if you’re a good fit for knee surgery. “This will be more evident with mechanical issues, such as bone-on-bone arthritis, fracture, bone erosions or other identifiable structural issues,” explains Dr. Chen. “Even if such conditions make someone a candidate, I encourage patients to attempt nonoperative management, such as [physical] therapy, to strengthen the knee, as it can not only improve your current condition but will also at least prepare you for surgery.”
Dr. Chen says he encourages his patients to ask themselves these three questions to help them decide if it’s worth talking to their doctor about knee replacement surgery:
- Am I unable to exercise even after short periods of rest?
- Is my instability severe enough that I’m falling?
- Is my knee pain persistent and impacting my daily activities?
If you answered yes to one or all of these questions, it could be time to talk to your doctor about a knee replacement to improve your quality of life.
How to manage knee pain while you wait for surgery
Whether you’re still on the fence about knee surgery or have the appointment booked and have to wait a bit, Milica McDowell, doctor of physical therapy with over 20 years of experience, provides tips to ease discomfort in the meantime.
Keep moving
“Gentle activities such as walking, riding a stationary bike or swimming can be helpful in order to improve range of motion around the knee, maintain or improve muscle strength, boost your cardiovascular fitness and improve your mood,” explains McDowell.
Switch up your footwear
“Look at your footwear and make sure you’re wearing shoes that support you from the ground up,” says McDowell. “Shoes that have a wide toe box, a low stack height and are flexible can be helpful for those who have knee issues.”
Maintain a healthy weight
“Being an ideal weight for your height has been demonstrated by numerous studies to help reduce discomfort in the knee,” says McDowell. “This should be a conversation with your healthcare or fitness team in order to address if this is a recommendation that would be appropriate for you.”
Find a support group
“In some cases, physical therapists or orthopedic surgeons will have walking groups or individuals who exercise together in order to try to improve their range of motion and strength,” adds McDowell.
The bottom line
By educating yourself about your options, trying proven pain management strategies and partnering with your healthcare team, you’re taking powerful steps toward reclaiming the active, joyful life you deserve. Whether you choose knee replacement surgery now, later or find relief through other methods, you’re in control.
About the author
James B. Chen, MD Dr. James B. Chen is a highly skilled, fellowship-trained orthopedic surgeon specializing in hip and knee total joint replacement. Read more articles by James B. Chen, MD.
