Our goal is to prevent joint replacement surgery for as long as possible with more conservative methods (non-operative as well as operative). However, there are many times when joint replacement is indicated.  Some of the most common indications for joint replacement are osteoarthritis, rheumatoid arthritis, and osteonecrosis. The common characteristic of all these diseases is the eventual destruction of joint cartilage. When this cartilage wears away, the result is a painful joint. If the condition is severe enough, these joints need to be replaced.