One of the most frequently asked question by patients is how will they know when the time is right to proceed with joint replacement. This is a multifactorial process that involves the evolution of symptoms, the use of nonoperative/symptomatic treatment, and the degree of research the patient does on treatment options. Most patients will seek some form medical evaluation when they start to experience pain in a weightbearing joint. At the onset of symptoms, which as typically pain and decreased function, often symptomatic treatment in the form of oral anti-inflammatory medications and/or injectable-type medications can greatly alleviate the discomfort and often the patient can go on to function for quite some time with this form of treatment. As the disease process progresses, the use of symptomatic treatment options becomes less effective and the patient continues to have discomfort. At this point, when symptomatic treatment ceases to help, pain increases and function decreases, often the patients will return to the physician to have further discussions. As these symptoms increase patients come to the realization that surgical intervention may be the most conservative treatment to get them back to a reasonable level of function.. Most people will reach the decision to have surgery in form of a joint replacement as the pain increases to the point where it is limiting daily activities and making function difficult. The combination of these symptoms and a radiograph that shows loss of joint space, due to the articular damage from osteoarthritis and/or inflammatory arthritis, are factors that lead the patient and the surgeon to pursue joint replacement.
