I've said this to a lot of people recently. Just because an X-ray (which captures one moment of time in a non moving joint) shows wear and tear and just because the surgeon says the picture shows "Bone-on-Bone", it does not AUTOMATICALLY mean you need a joint replacement. Especially if there is only "occasional" pain or the pain "comes and goes". Because, now think about this...the Bone-on-Bone situation is always there right? And if this situation was causing the pain, wouldn't the pain also always be there??? Are there times when it's necessary, sure, should you exhaust all options first!? Absolutely. Find yourself a great PT!