Total Knee Replacement (TKR) is the last option offered for Knee Arthritis, to improve function and reduce pain in the joint. Usual indications for surgery are, when medicines, physiotherapy and knee braces have failed to improve your condition, pain is severe, inability to perform activities you normally do on daily basis, need for frequent pain medications, deformity in the knee joint, stage III or IV arthritis on x-rays. All these features indicate you need a total knee replacement.