Dear Doctor, I am 73 years old (DOB 30/03/1941) male. Recently, I developed pain in my Right Knee. I went to the Orthopaedic Surgeon who had carried our orthoscopic about twenty two years ago. He had the removed bits of cartilage and since then I had no problem. This time he saw my X-rays (copy attached) and said that I needed replacement surgery ? first to the right knee and then to the left knee. On request he prescribed Tab Nucoxia 90 and Vitamin E 400mg. I am diabetic (2) and have high blood pressure, both under control with medication. A pacemaker was implanted on 01/06/2012. It is working fine as per my last check up on 03/11/2014 (next check-up due on 3/5/2013). I am having following medicines ? Tab NatrilAm, Tablet Telma (80), Ecosprin (75), Urimax (0.04), Metosartan (1000) BD, Trajenta (5), Amaryl (2), vitamins and calcium). My request is to advise:- 1. Is there an alternative to surgery? Is Joint replacement surgery a must? 2. Is Tab Nucoxia 90 safe with the medicines I am taking, and how long should I continue?