UNC Health Talk

Are You Ready for Joint Replacement Surgery?

Do you have recurring or chronic joint pain, maybe in your knees when you climb the stairs or your hip when you bend over to tie your shoe? If you’ve tried everything from over-the-counter pain medication to wearing a brace and steroid injections to alleviate your pain, joint replacement surgery may be your best option for relief.

We talked to UNC Health orthopedic surgeon and joint replacement specialist Demetri M. Economedes, DO, about how to know when it’s time to have a joint replaced.

Arthritis Can Lead to Joint Replacement

The ends of your bones come together to form joints. Articular cartilage is the smooth tissue that covers your joints, and over time, as you age, that cartilage can wear down. When the cartilage wears down or is gone completely, the bones rub together, causing pain and mobility problems.

“We can replace hips, knees, shoulders, elbows and ankles, as well as discs in the spine, but the most commonly performed are hip and knee replacements,” Dr. Economedes says.

The most common cause for joint replacement is arthritis—osteoarthritis, inflammatory arthritis or traumatic arthritis.

“Osteoarthritis is your typical wear-and-tear pattern. Alternatively, inflammatory arthritis is a systemic cause of inflammation that will also affect cartilage, but in a different process. This would include rheumatoid arthritis,” Dr. Economedes says. “Lastly, you can have traumatic arthritis. This is brought on by fractures that occur through a joint. Ultimately, the body cannot repair articular cartilage in any of these situations and that is why if nonsurgical treatment fails, joint replacement is the final option.”

Nonsurgical Options for Joint Pain

Before joint replacement surgery is considered, your doctor will try nonsurgical options. These include nonsteroidal anti-inflammatories such as ibuprofen, physical therapy and cortisone (steroid) injections into the joint.

If you no longer have cartilage in your joint and conservative measures such as nonsteroidal anti-inflammatories, injections, bracing or physical therapy have yet to alleviate your pain, you may be a candidate for joint replacement surgery. In this surgery, parts of your joint are removed and replaced with metal, plastic or ceramic implants.

“Joint replacement surgery becomes an option after all conservative measures have failed,” Dr. Economedes says. “It’s meant to alleviate a person’s pain, restore their function and get them back to the activities that they enjoy, whether that’s playing a sport, enjoying their grandchildren or just being able to walk in the grocery store and maintain a level of independence.”

Heading into Retirement with a New Hip and Knee

UNC joint replacement patient Sally
Sally, one week after her knee replacement

Sally Cameron spent nearly four decades as the executive director of the North Carolina Psychological Association. As she neared retirement, she began to experience excruciating hip and knee pain.

“I just couldn’t walk like I wanted to,” Cameron says. “I was on vacation in Nova Scotia, and the one day I wanted to go to this wonderful museum, my husband had to push me around in one of those transport chairs because I could hardly walk.”

Cameron had her hip replaced in 2018, followed by a knee replacement in 2020.

“It was a life choice,” Cameron says. “I wanted to get it done while I still could do the post-surgery exercises and fully recover.”

Today, Cameron, who is in her 70s, enjoys volunteering, traveling, walking and spending time with her family and friends. She’s glad she opted for surgery when she did.

“I know people who waited too long, and that made their surgery and recovery much harder,” Cameron says. “Don’t wait until it’s so bad that you cannot fully recover.”


Do your joints hurt? Talk to your doctor or find one near you.