I want to put off having a knee replacement for as long as possible

Photo of a woman with a bicycle

Annie, 50 years old

“I just couldn't believe it: Not even 50 years old and my knee was totally wrecked. But I wanted to put off having a knee replacement for as long as possible.”

I noticed the first signs when I was in my mid 40s, about five years ago. I felt a strange twinge in my knee, particularly when I was going down stairs. At first, I just bravely ignored it, thinking it would go away by itself just like it came.

When it didn't go away, I first tried out some home remedies that were supposed to be cooling and relieve the pain. They didn't really help, though. So I went to see my family doctor. He recommended that I continue cooling it, and prescribed me a cream. But that didn't make it any better, either.

Along with the relatively tolerable pain when climbing the stairs, I also noticed that certain exercises and movements were very painful when doing sports.

The orthopedic specialist tried all sorts of things

Then I went to see an orthopedic specialist. He did an x-ray and suspected I had osteoarthritis, but he didn't find anything particularly bad. He prescribed me a whole host of treatments based on physical stimuli, from electrotherapy to cryotherapy. I was also referred to a , but I had to fight a little bit to get that.

Despite all of those therapies, the pain didn’t really go away. He then suggested . I wasn’t sure whether that would have any effect. But is an authorized treatment for osteoarthritis so I thought I could give it a whirl.

The only positive effect of the was that I found the half hour lying down in the practice very relaxing, a kind of break from everyday life. It had no effect apart from that, though.

A potpourri of diagnoses

At some stage, I had an appointment with my rheumatologist again. I also suffer from rheumatism. I told him about my knee problems. He examined me, found my legs to be different lengths, and said that was the reason for my knee problems. He prescribed me shoe insoles and said that ought to solve the problem.

I went to the medical supply store with the prescription. They examined me there as well, and didn’t find a difference in the length of my legs. They said my legs were exactly the same length and that my pelvis was straight.

The pain got worse over the following months, so I went to see the orthopedic specialist again. He examined me again and said he had never noticed that I had knock knees. He suspected they might be the cause of my knee problems, and said that I could have surgery to straighten my legs. He referred me to the hospital.

There they carried out a number of examinations to prepare for the surgery. The end result was that they did not recommend leg-straightening surgery. They said I had straight legs even though they might not look straight. They recommended having a keyhole procedure instead. I then asked if they could do an MRI scan, but they said no. I then went to another outpatient clinic to ask for a second opinion.

Finally, the correct diagnosis

They said I should have an MRI scan. The scan showed that I did actually have osteoarthritis. The doctors recommended arthroscopy to check whether there were any inflammations or mechanical problems. I had that done.

They then found out that I had advanced osteoarthritis. They told me frankly that I would soon need a knee replacement. But they also told me that I had time to think about it and didn't need immediate surgery. Then they discharged me.

I just couldn't believe it: Not even 50 years old and my knee was totally wrecked! I wanted to put off having a knee replacement for as long as possible. For as long as I could somehow cope.

Part of the reason why I decided to wait was because a joint replacement doesn’t last forever. The earlier I had it done, the more likely it would have to be replaced at some point. An operation like that is a major procedure that, along with the necessary rehabilitation program, would see me out of action for a long while. And there is also a risk of complications. I think the longer I can put it off, the better.

I am responsible for my knee

After receiving that news, I tried to incorporate even more exercise into my daily routine. I bugged my orthopedic specialist forever, asking to be prescribed physical therapy. I learned exercises in physical therapy that I can also do at home. And I also requested a prescription for a special group exercise course, to be able to train regularly in a group of people with similar health issues. I went swimming more often, too, because I found it offered a lot of relief for my knee.

I adjusted my diet and lost some weight. I tried to avoid unhealthy food as much as possible, ate plenty of fruit and vegetables, and drank a lot of water and herbal tea. I generally paid more attention to a healthy diet.

Every kilogram I lose is good for my knee. The pain has actually got a bit better now that I've lost some weight. And I can move my leg a bit better now, which I also notice when I go swimming and cycling.

I gradually incorporated more and more exercise into my daily routine. For instance, I always tried to walk one stop further when I was using public transport. I bought a pedometer, too, so that I can keep an eye on how much exercise I'm doing. It’s great when I've sometimes already done my 10,000 steps by lunchtime! Exercise has now become a very important part of my day and my wellbeing.

The pain is there, but it's bearable

I notice my knee when I take the stairs or do certain movements. It often depends a little bit on how I'm feeling on a given day or how much exercise I've already done that day. The pain is there but I can cope well with it, and it hasn’t got worse. It no longer governs my life like it did at first. Maybe I've simply got used to it over time.

I keep an eye on how much strain I put on my knee each day. I know my limits. My knee swells up a bit when it has been under more strain, and sometimes even becomes a little stiff. That's uncomfortable and I can’t move or stretch my leg out properly. It really restricts my mobility. If it gets really bad, I put a cool pack on my knee and that makes it better.

I have no trouble getting a good night's sleep. But it does take a few attempts to get going in the morning, or if I've been sitting down for a long time. It's really painful at first, but then it gets much better. It’s as if I have to crank my knee up a little.

Personal responsibility is very important

My own personal responsibility is very important to me. I don't want to see myself as a victim. I see it as my responsibility to do everything I can to put off having a knee replacement.

I would probably have surgery if I get to a point where I can no longer move without pain, and where my mobility is very restricted. Then I would seriously consider having an operation.

I don’t have a car and I either walk, take public transport or cycle everywhere. If my knee got so bad that I could no longer go where I wanted to, and if my quality of life suffered as a result, I wouldn't hesitate. Always asking my husband to drive me everywhere is out of the question. My independence is very important to me.

A lot of weird things were recommended to me

My husband was very kind and understanding about the . He takes pressure off me and helps when I need it. He was very understanding from the beginning.

But he also often gave me advice that I hadn’t asked for. Friends and acquaintances cut out newspaper articles about random magic remedies, and recommended things that I should absolutely try out, without me ever asking them to. Or told me about food supplement pills that I should pop. I found some of those things pretty weird. They might keep the manufacturer’s bank account healthy, but they do nothing for me. I'm a pretty rational person and prefer evidence-based treatment approaches.

I found conversations like that quite hard work, and had to learn to react firmly but diplomatically. I imagine that a lot of people with chronic illnesses are often given tips and suggestions that aren't always helpful, without ever asking for them.

I didn't give up

It was important to me not to give up until I had a conclusive . It's not always easy to stand your ground when dealing with doctors, but it's important to me and is part of my responsibility for my own health.

I also think it's up to me to look after myself and to slow down the progression of the osteoarthritis as much as possible… to do as much as I can as a patient. It might sound odd, but it feels good to have done everything I could to put off having to have a knee replacement. If I want to be seen as a responsible patient, I think it's important that I take myself seriously as well and do everything I can to help myself.

I've done that well so far. I still have my own knee and I'm very happy about that.


Our real-life stories summarize interviews with people who are affected by the medical condition. Our interview partners have given us permission to publish their stories. We would like to express our sincere thanks to them.

The real-life stories give an insight into how other people cope and live with a medical condition. Their opinions and comments are not recommendations by IQWiG.

Please note: The names of our interview partners have been changed to protect their identity. The photos are of models.

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Created on January 12, 2022

Next planned update: 2025


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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