Is It Time for a Knee Replacement? 6 Signs It’s More Than Just ‘Wear and Tear’
Published by Dr Oliver Khoo at Monday, August 11, 2025
Knee pain is something many people expect to feel as they get older — a little stiffness in the morning, some aches after a long walk. But for some, those symptoms stop being just a background nuisance and start to dictate how life is lived.
That’s often the point when patients ask, “Is this still just wear and tear, or is it something more?”
As an orthopaedic surgeon, I’ve seen that knowing the right time to consider knee replacement surgery isn’t always straightforward. Here’s a guide to help you recognise when it might be time to have that conversation with your doctor.
In early osteoarthritis, knee pain usually comes and goes. You might feel discomfort after long walks or a big day in the garden, but it fades with rest.
When pain becomes constant — even at night — it’s a sign that the cartilage damage has likely progressed. If it’s stopping you from sleeping or waking you in the middle of the night, conservative treatments may be losing their effectiveness.
Struggling to walk to the letterbox, climb stairs, or stand from a chair without bracing yourself on something are red flags. These are more than inconveniences — they indicate functional loss, one of the strongest predictors that surgical intervention may be beneficial.
Healthy knees should bend and straighten freely. If stiffness makes it difficult to fully extend or bend your knee, especially after trying physiotherapy, the underlying joint damage might be significant enough to consider a replacement.
Occasional swelling after intense activity can be normal. But persistent swelling, warmth, and tenderness — despite rest, ice, and medication — often point to ongoing joint inflammation that’s not improving with non-surgical care.
Most patients start with non-surgical options:
Pain doesn’t just affect the knee — it affects mood, sleep, and independence. If you’re turning down social invitations, avoiding travel, or missing out on favourite hobbies because of knee discomfort, it’s worth discussing whether surgery could help restore your lifestyle.
Not every knee ache needs replacing. If your pain is mild, responds well to exercise or medication, and doesn’t limit your activities, surgery can wait.
In fact, replacing a joint too early can increase the chance of needing revision surgery later.
A proper diagnosis starts with a conversation, a physical examination, and imaging — usually X-rays or MRI.
If surgery is appropriate, modern knee replacement techniques have excellent success rates and can dramatically improve mobility and comfort.
1. How long does a knee replacement last?
Modern knee replacements can last 15–20 years or more, depending on activity levels and overall health.
2. Is the surgery painful?
You won’t feel pain during the operation itself. After surgery, pain is managed with medication and physiotherapy, and most people notice a significant improvement compared to their pre-surgery pain within weeks to months.
3. How soon can I walk after surgery?
Most patients stand and take a few steps with assistance within 24 hours after surgery. Walking ability improves steadily with guided physiotherapy.
4. Will I need another knee replacement later?
If you have surgery at a younger age or place heavy demands on the joint, there’s a higher chance you might need a revision later. This is why careful timing is important.
5. Can knee replacement be avoided?
Sometimes. Early arthritis can often be managed with physiotherapy, activity modification, weight management, and injections — delaying or avoiding surgery.