When is the right time to get a knee replacement, and when can it be postponed? While there are no universally accepted medical guidelines to follow, there are several factors that doctors and patients can consider when deciding when to schedule or postpone surgery.

Delaying Surgery Because of Potential Risks

Everyone who elects to have knee replacement surgery must weigh the potential benefits against the potential risks. Smoking, obesity, poor circulation, and certain other pre-existing medical conditions can increase the risk of postsurgical complications, such as infection.

Total Knee Replacement Risks and Complications

People with serious concerns about their potential risks may postpone surgery indefinitely or until they can take steps to reduce their risks.

Many people decide to schedule knee replacement surgery after they have quit smoking, after they have lost a certain amount of weight or improved other modifiable risk factors such as diabetes control.

How to Prepare for Total Knee Replacement


Scheduling Surgery to Maximize Recovery Time

Knee replacement is a major surgery, and a full recovery can take 6 months or longer. For most people, it does not make sense to schedule a knee replacement right before a big life event, like a move, family wedding, or an active vacation.

Total Knee Replacement Surgery Recovery

Commitment to physical therapy
A successful recovery typically requires a patient to attend physical therapy appointments. Physical therapy may be prescribed a couple of times per week for 6 to 12 weeks. The patient will also be expected to do knee and hip stretches and strengthening exercises at home.

Knee Replacement Surgery Rehabilitation Exercises

Potential patients should consider whether they have the time to commit to physical therapy before electing to have surgery. People who know they do not have time for recovery and rehabilitation may decide to postpone knee replacement surgery until a time that they do.

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Scheduling Surgery to Lower Costs

How much will the surgery cost? How much will be covered by insurance? Some people who are uninsured or underinsured decide to postpone surgery until they get better insurance. For example, people who do not have insurance may wait until they are eligible for Medicare before scheduling knee replacement surgery.

Lowering indirect costs
In addition to medical bills, there can be indirect costs related to knee replacement recovery. Purchasing pet care, home cleaning services, taxi rides, and prepared meals are all examples of indirect costs. To limit indirect costs, some people schedule their surgery around relatives’ or close friends’ vacation schedules, ensuring at-home help will be available.

Lowering opportunity costs
Taking several weeks off of work to have knee replacement surgery can result in lost wages, making the surgery less attractive. Alternatively, knee arthritis pain may prevent some people from working to their fullest potential. In these cases, knee replacement surgery may be an economically wise choice. It is up to the patient to evaluate opportunity costs.

Coping with Knee Pain Until Surgery

If a patient decides to postpone knee replacement surgery, a doctor can recommend options to temporarily relieve arthritic knee pain.

For example, a person who wants to postpone surgery for 6 to 12 months may be able to get one or more cortisone or hyaluronic acid injections to reduce his or her knee pain.

See Therapeutic Injections for Knee Arthritis

Other people may choose to take prescription strength nonsteroidal anti-inflammatories (NSAIDs), such as ibuprofen and naproxen. NSAIDs can have negative effects on the stomach and liver if taken long-term, but they may be an acceptable temporary solution.

See Knee Osteoarthritis Treatment


The Choice is Up to the Patient

There is no right or wrong answer when it comes to scheduling knee replacement. Some people may decide they want to avoid surgery indefinitely and reduce knee pain using a combination of nonsurgical treatments. Other patients may use nonsurgical treatments just to get them through another year or so of working, after which they can retire and devote time to postsurgical recovery. Still, other people may decide they need to have knee replacement surgery as soon as possible in order to work effectively or get more enjoyment out of day-to-day living.

Dr. J. Stuart Melvin is an orthopedic surgeon specializing in orthopedic trauma and joint replacement surgery. He practices at Washington Orthopaedics and Sports Medicine. Dr. Melvin is a reviewer for the Journal of Arthroplasty, has contributed chapters to several medical textbooks, and has had numerous scientific papers published in academic journals.