When a patient visits an orthopedic clinic due to recurring knee pain episodes, the patient often asks, “Do I have to have an artificial joint replacement? Is there an alternative treatment?” The only way to achieve the desired outcome of any treatment is through communication, understanding and cooperation between the patient and the doctor, so today we will give a brief introduction to our patients. When to consider knee replacement? Any surgery must have clear indications. Knee joint pathology due to various causes, resulting in serious impairment of knee function, long-term pain, walking difficulties, dysfunction, common joint deformities including inversion of the knee (O-leg), valgus knee (X-leg), flexion deformity, knee stiffness, seriously affecting the patient’s quality of life, and other conservative treatment failed to improve, or there is no more Knee replacement may be considered if other conservative treatments have failed to improve, or if no more effective treatment is available. The most common causes are osteoarthritis of the knee in the elderly and rheumatoid knee arthritis in young and middle-aged people. Absolute contraindications to knee replacement include: recent septic infection of the knee, active tuberculosis; discontinuity or severe loss of function of the knee extension device; retroflexion deformity secondary to muscle weakness and painless, well-functioning knee fusion. Relative contraindications include poor general condition, severe cardiopulmonary, hepatic and renal disease, and significant arteriosclerosis of the affected limb. A consultation with an expert in joint surgery, a comprehensive and detailed physical examination, and, if necessary, a thorough consideration of both the patient and the physician are required, within the limits of their abilities. In short, everything must be done with the patient’s life safety and quality of life in mind. What preparations should be made before surgery? Since most patients are old and frail, the patient’s physical condition should be fully evaluated in detail to ensure the safety of the surgery. At the same time, the affected lower limb and knee should be carefully examined to assess the skin condition, vascular condition, ligament function, joint mobility, deformity, etc.; front and side X-rays of the knee, axial X-rays of the patella, and full-length X-rays of the lower limb in standing position should be taken to understand the bone quality, bone defects, anatomical structure, and force lines. Diseases such as diabetes, hypertension, coronary heart disease, rheumatoid, liver and kidney disease, and skin problems will pose risks to the surgery, therefore, a good preoperative evaluation needs to be given, and if necessary, a consultation with the relevant departments should be requested to give proper control, which will help to improve the safety of the surgery. Therefore, for joint replacement surgery in the elderly, it is not just the joint surgeon who can solve all the potential risks, but also requires the support and collaboration of a strong group of disciplines in the hospital where it is performed, including different disciplines such as cardiovascular, respiratory, ICU, neurology, and rehabilitation. What is done with knee replacement? The surgical approach uses an anterior median incision to obtain a balance of the medial and lateral soft tissues of the knee, a reasonable osteotomy, selection of a suitable size prosthesis, correct placement of the femoral and tibial prosthesis, reasonable rotational positioning of the prosthesis, and a good patellofemoral trajectory. If there is a bone defect, it should be treated accordingly to the type of defect. Knee replacement is a technically demanding procedure that is closely related to the surgeon’s surgical experience, the number of surgeries performed each year, and the need for skilled surgical technique. Some people call it “millimeter engineering”, meaning that a difference of 1 millimeter can cause a different result, which shows how delicate and precise the surgery is. What is the life span of an artificial joint prosthesis? Although modern artificial joint prostheses are very delicate and ingenious, they cannot be compared with the original joints of the human body, and artificial joint prostheses, like many other commodities, have a certain service life and cannot be used indefinitely. Just like when it comes to human life, due to the different conditions and habits of each person, life expectancy is also different, the same reason, specifically to each patient artificial joint prosthesis in the end how long can be used, the doctor can not give an accurate prediction, this is related to many factors, such as obese patients, artificial joint load, the service life will be short; young patients are more active, will lead to artificial joint excessive wear The use of artificial joints can be easily affected by aseptic loosening, etc. In practice, we have found that some patients may have less than the average service life of the artificial joint, but others may have much longer than 20 years or even longer. For patients younger than 65 years of age who require an artificial joint replacement, they will face the problem of replacing the joint with a new prosthesis in the future, and revision surgery is often more difficult and more likely to fail than the initial surgery, and less effective than the initial replacement surgery. In conclusion, artificial joint replacement surgery offers a new option for patients that can greatly relieve the pain of people with severe joint disorders, but also has limitations and is a better option for those who desire and seek a better quality of life.