Is it a bad idea to postpone joint replacement surgery?

Question: Is it a bad idea to postpone joint replacement surgery?

Answer: The rule of thumb for when to have a joint replacement is when no other treatment adequately relieves your pain. Treatments are available for arthritis, including glucosamine, anti-inflammatory medications, cortisone injections, physical therapy, and others. Only when these treatments no longer provide adequate relief should a joint replacement be considered.

It is true that as arthritis progresses, the normal joint erodes away. However, progression of arthritis seldom makes a joint replacement harder to perform. The surgical procedure is the same even when arthritis is in its latest stages. For people with severe joint arthritis, it may be worthwhile to regularly see your orthopedic surgeon if you are concerned about the progression of your arthritis.

Is there any reason to have a joint replacement now?

Patients should not become sedentary because of bad joints -- that can lead to other health problems that are harder to manage than worn-out joints. Patients who are sedentary risk gaining weight, losing cardiovascular fitness, and developing other medical problems. It is important to be able to exercise. And if you cannot get regular physical activity because of joint pain, joint replacement may be something to consider before becoming sedentary.

Studies have shown that patients who are healthier going into joint replacement surgery tend to have better results after surgery. Therefore, it is important to consider your overall health and fitness when deciding whether to have joint replacement.

So if I have pain when exercising, I should have joint replacement?

The decision to have joint replacement should not be confused with preference of exercise! Just because you cannot participate in impact sports, such as basketball or jogging, does not necessarily mean that joint replacement should be done. People should try to participate in low-impact fitness activities, such as cycling and swimming, rather than impact sports. Only when these low-impact activities become difficult should joint replacement be considered.

_Source:

Fortin PR, "Timing of total joint replacement affects clinical outcomes among patients with osteoarthritis of the hip or knee." Arthritis Rheum. 2002 Dec;46(12):3327-30.