Surgery for osteoarthritis

Is surgery right for osteoarthritis?

For most people, osteoarthritis symptoms improve with exercise, education, and lifestyle changes, and surgery is not needed¹. Still, surgery can be worth discussing if osteoarthritis is seriously limiting your life.

Surgery may be considered when:

• Pain is severe and persistent, even after a well-supported plan with exercise, medications, and other options¹
• Daily function is strongly limited, like walking short distances, climbing stairs, sleeping, or doing basic self-care¹
• Quality of life has dropped in a way that feels unacceptable to you.
• The joint is very damaged, and your symptoms match what a clinician sees on exam and imaging¹

Surgery is not the automatic “next step.” It is a shared decision based on your goals, your overall health, which joint is involved, and what risks you are comfortable with.¹

Common surgical options for osteoarthritis

Different joints have different options, but these are the most common surgeries people hear about:

1. Total joint replacement (arthroplasty)
   • Replaces the worn joint surfaces (most commonly knee, shoulder or hip) to reduce pain and improve function.
   • Usually considered when osteoarthritis is advanced and daily life is heavily affected.¹
2. Partial joint replacement
   • Replaces only the most damaged part of a joint (for example, part of the knee).
   • May be an option for select people with damage in one area of the joint.¹
3. Joint fusion (arthrodesis)
   • Permanently joins bones to stop painful joint movement (more common in some hand or ankle arthritis situations).
   • Can reduce pain, but it also reduces motion in that joint.²
4. Arthroscopy (using small holes and a camera) for removal of worn tissues  of degenerative knee disease
   • Often discussed, but for most osteoarthritis-related knee pain, expert guidelines strongly recommend against routine arthroscopy because it does not meaningfully outperform non-surgical care for typical degenerative disease.³

What to expect during recovery

Recovery depends on the joint, the exact procedure, and your health going in. Most recoveries follow a few predictable phases.

Right after surgery (first days to 2 weeks)

• Pain, swelling, and fatigue are common.
• Many people start gentle movement quickly, with a plan for walking and daily tasks.You may need to use crutches. 

Early recovery (weeks 2–6)

• You gradually rebuild basic function like walking, stairs, and getting in and out of a chair.
• Sleep disruption and stiffness are common, especially early on.

Rebuilding strength and endurance (6 weeks to 3 months)

• Most people focus on strengthening, balance, and confidence with daily activities.
• Improvements often continue for months after surgery.⁴

Longer-term recovery (3 months and beyond)

• Many people keep gaining function over time, but recovery is not the same for everyone.⁴

Possible risks and setbacks to know about

Surgery can be very helpful, but it also has real risks. Depending on the procedure and your health, risks can include infection, blood clots, stiffness, ongoing pain, and the possibility of needing another procedure later.¹ Also, a meaningful number of people report ongoing pain or less-than-expected improvement, especially after knee replacement, which is why expectations and preparation matter.^{4 5}

Can surgery be avoided?

Often, yes.

Guidelines consistently recommend exercise, education, and self-management as first-line care for osteoarthritis, and many people can reduce pain and improve function without surgery.^{1 6} Even when osteoarthritis shows up on X-ray, symptoms can improve a lot with the right plan.

Conservative care can help you:

• Build strength so the joint feels more supported
• Improve walking, stairs, and daily activities
• Reduce flare-ups through pacing and load management
• Feel more confident moving again

[Physical Therapy for Osteoarthritis →]

Sword note (about conservative care support): In high quality studies in chronic musculoskeletal pain, fully remote digital rehabilitation programs have achieved similar improvements to in-person physiotherapy, with strong engagement and satisfaction.⁷

How Sword can support you before and after surgery

Physical therapy can play an important role in preparing for surgery, supporting recovery, and, in some cases, helping people manage symptoms without surgery. Sword offers physical therapy programs designed to support you at different points along that journey.

Sword supports recovery before and after surgery, with care designed to fit into your life. You receive high-quality physical therapy at home, guided by licensed clinicians and supported by smart technology.

• Care that adapts as your body and recovery needs change
• Licensed physical therapists guiding your care at every stage
• Non-invasive, evidence-based physical therapy programs

Support for preparation, recovery, and long-term movement health

Clinical insight

NICE guidelines recommend considering referral for joint replacement when osteoarthritis symptoms substantially affect quality of life and non-surgical options have not helped enough or are not suitable, and they emphasize shared decision-making and individualized risk discussion.¹