Not relieved by other methods
Before undergoing joint replacement surgery, a patient would typically have tried other, simpler methods to help the pain. For example, if the pain is triggered only by running but otherwise is not bothersome, then it would be better to stop running. There would be no need for other treatment and total joint replacement would not therefore be indicated in such a patient.
Achievement of ideal body weight is also extremely important. Obesity is associated with premature wear of the previously normal joint and is a significant risk factor for premature osteoarthritis. It can lead to premature wear of the artificial joint as well. It makes the operation more difficult to perform and is associated with higher rate of post-operative complications. In addition, many patients, who successfully loose weight, will have significant improvement in the pain and therefore delay the need for surgery.
Other forms of treatment include medications, injections, braces and physical therapy. If they have been tried and do not work than the next step may need to be a total joint replacement.