How Bad Should My Knee Feel Before Getting Knee Replacement?

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Have you had knee pain for a long time and can’t handle the pain anymore?

You may be thinking about having knee replacement surgery. The surgeon may have already told you that you need TKR surgery.

You may have been putting the surgery off like me until the pain and lack of mobility became unbearable. TKR surgery is a big decision and it took me a long time to decide to go forward with the surgery.

Delaying TKR can greatly affect your lifestyle by not allowing you to enjoy the activities that you choose to participate in. Delaying the surgery can cause further wear on the joint, your leg may begin to bow and it can also cause you to develop a limp when walking (I know because both happened to me).

The doctor can tell you that you need the surgery but you are the only person who can determine how much pain and inconvenience is enough.

In my case the results were amazing and I often wonder if I should have had the surgery sooner.

My Predicament: How Long I Waited Before Getting Knee Replacement

I waited over 15 years after my first orthopedic surgeon told me I was a candidate for TKR. He told me that it was up to me and that when the pain became too much for me to handle that I should come back and make an appointment for TKR.

I had had two previous meniscus surgeries in my 20’s. There had always been some pain after those surgeries.

The pain increased slowly over a period of 40 years and I just lived with the pain. By my early 60’s the pain was severe, I had developed a limp and my leg had begun to bow.

I was still fearful of the procedure and wanted to put it off as long as possible. After many non-invasive procedures (cortisone shots and hyaluronic acid injections) and after two visits to two different orthopedic surgeons who both wondered how I was even walking, I made my decision to go forward with the surgery.

After doing the surgery the doctor told me that the wear was extensive and he was surprised I was able to wait as long as I had.

Severity Of Pain vs Patient Age vs Life Span Of Knee Replacement

If you are like me, I was concerned that if I had the surgery too soon that I might wear out the new joint and need another replacement later on. I had been told that the life of a knee replacement would be 15-20 years.

I preferred to wait and tolerate the pain so that the knee joint would outlive me. I did not want to have the surgery in my late 40’s or early 50’s hoping that new medical improvements might eliminate the need for surgery or that a better, longer lasting knee replacement might be developed.

These are all thoughts that went through my mind while I was considering TKR.

If the pain was sudden and had come on without notice I may have thought different. But, when the pain slowly increases over a period of 40 years you learn to live with it.

Is It Possible To Wait Too Long Before Getting Total Knee Replacement

There are definitely some disadvantages of waiting too long to have TKR. First, you don’t need to be enduring the pain that you are living with now.

My bone on bone pain is completely gone. As your bone wears you develop a limp that affects other parts of your body.

You may be making other parts of your body overcompensate for your bad knee. You may be putting undue stress on your hip and discover that it is causing you pain.

My hip was painful before surgery after long walks. Since my surgery, there has been no ache or pain in my hip.

The longer you wait and age, your body might not be able to heal and bounce back like it did when you were younger. The better shape that you are in prior to surgery the better the recovery.

On A Scale Of 1 to 10: How Bad Should A Knee Feel Before Getting Knee Replacement

Each person’s pain tolerance is different.

It is hard to say when someone’s pain level reaches a certain point (on a scale of 1 to 10) that TKR is necessary. You have to assess your own quality of life and your own ability to tolerate knee pain.

The clincher for me was not so much the pain but the quality of life. I could no longer walk the beach, participate in golf or pickle-ball without swelling and severe pain.

As I have mentioned before, my pain increased slowly over a period of 40 years and I just accepted it and learned to live with it. The last two years before my surgery I did notice a marked increase in pain during walking and recreational activity.

I did not experience pain while trying to sleep or while doing everyday things around the house. Other people noticed that I limped more and looked like I was in pain.

It was at my son-in-law’s (he is an ear, nose and throat surgeon) suggestion that I finally saw an orthopedic surgeon and made the decision to have TKR.


Friends, family, and doctors can tell you that you need TKR. You are the only person who can feel the pain and decide when it is too much to endure.

Everyone is different.

If your pain tolerance is low you may not be able to put it off. If you can live with the pain and enjoy the activities that you participate in, you may be able to put off TKR surgery for a time.

I put it off for years. After finally having the surgery I was amazed that I no longer had any pain at all. I got to the point where I was limping, my leg was bowing and I was tired of the constant pain.

I’m happy with the decision I made to have surgery. I could have had it earlier but there is no point in looking backward.

I now look forward to 15 to 20 years of a well functioning knee that will allow me to participate in the activities I enjoy without pain. When all is said and done only you can decide when the pain has reached its’ limit.

Try non-invasive techniques, consult your doctor, get a second opinion and then make an intelligent decision.

4 thoughts on “How Bad Should My Knee Feel Before Getting Knee Replacement?”

  1. I had both knees replace in 2002 (6 months apart). I was 51 and it was probably a combination of extremely active lifestyle and weighing too much. Pain was sudden onset and the orthopedist said both were bone on bone but we’d do the painful knee first. I swear that when I came out from under anesthesia with the first knee, and as intense as the pain was, it felt better than it did prior to surgery.
    With my new knees, I was able to do Machu Pichu, Moscow, St Petersburgh and several other adventures. As predicted, in 2016 and 2017 I had revisions done to my knees. Essentially, with the four surgeries, I lost several months to recovery, but between surgeries, I was totally good to go.

    • Thanks for sharing. I’ve heard from several people that were expecting to have TKR on both knees and it’s good to hear that yours were not only successful, but you felt relief after the surgeries. Those are some great adventures. Hopefully I’ll be able to cross a few off my list one day – I hear Machu Pichu is a tough hike with the elevation!

  2. My knee is bone on bone at one side. I have much pain in the upper, outer part of my calf, sometimes down toward my ankle, and in my shin. Is that part of my knee problem or something else unrelated? Right now I have no trouble walking, but hurts when getting up or sitting down (bending). Thanks, Ann

    • Thanks for the comment. I can only share my experience but I also experienced bone-on-bone pain. It’s best to speak with a medical professional on this issue.

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