The common causes of hip or knee pain are osteoarthritis and inflammatory arthritis. Osteoarthritis affects the cartilage and lubrication in the joint resulting in increasing intensity and frequency of pain over time. The normal wear and tear in older patients and the overuse of joints from work or sports are the main causes for osteoarthritis. Another contributing factor is damage from accidents or sports injuries.

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Inflammatory arthritis occurs when a person develops autoimmune disease such as rheumatoid arthritis, ankylosing spondylitis, or systemic lupus erythematosus where the body produces certain enzymes and factors which attacks the joint cartilage and ligaments. Some patients develop joint damage from avascular necrosis.

Symptoms indicating need for joint replacement surgery

• Pain – that is not controlled by medications, supplements, steroid and gel injections or previous keyhole surgery. Or when patient is unable to tolerate medicine side effects.
• Joint stiffness – stiffness to a point where daily activities are affected. It is also useful to note when basic everyday functions are becoming more laboured and difficult.
• Joint deformities – especially in the knees as these can severely affect your walking pattern, or cause pain in the back.
• Multiple joint involvements – with pain in both hips and knees. In such patients it will be difficult to get up from bed or chair to walk or climb stairs.
• Inability to do normal, daily activities – such as walking for 20 minutes or more, climbing stairs, or getting up from bed or chair. Obviously, at this stage, one’s basic mobility and independence are badly hindered. Best to address these promptly.
• Affecting lifestyle of active person – such as playing golf, tennis, or doing exercises to keep fit. Certain patients do not want to give up these regular pleasures and have the desire to resume enjoying these activities.
• Wheelchair or bedbound patients – regain mobility and independence. It is definitely no fun being stuck to a wheelchair or a bed. With surgery, a total reversal of mobility and independence levels is possible.

This article was verified medically by Dr Lai Choon Hin, orthopaedic and bone surgeon, AP Centre For Joint Reconstruction, Mount Elizabeth Novena Specialist Centre (Singapore).