<s>[INST] Hello sir.. My dad is suffering from acute pain and swelling in both the knees. Xray reports suggest that knees have been worn out. He is just 54 years old. Is it a good idea to go for knee replacement at this early age? I have read that Hylagen is a very good option too to prevent pain. kindly suggest if we can go for this option too? Thanks. Sharad [/INST] Hi, thank you for providing the brief history of your dad. A thorough musculoskeletal assessment is advised As you dad has knee pain which is acute in nature I don't think he needs knee replacement as of now. Due to aging there will be wear and tear of the weight-bearing joint. Also, taking an MRI of the knee will help understand if the soft tissues and ligaments are proper. If any particular ligament is torn out completely than a ligament reconstruction can help better at this stage. Also, I will recommend undergoing physical therapy as it is non-invasive and research supports that performing a good physical therapy will help your dad avoid knee replacement too. With the help of physical therapy the strength, ROM, flexibility, balance etc. can be achieved, and knee replacement can be avoided as well. Majority of my patients recover well with physical therapy and avoid knee replacements. Regards Jay In Chat Doctor.  </s>