Knee replacement surgery, otherwise known as a knee arthroplasty, replaces all of the weight-bearing bone structure in your knee. A knee replacement helps to restore pain-free mobility in patients who are suffering from end-stage osteoarthritis, or physical injuries. But when is the right time? The progression of the arthritis or injury, the patient’s reaction to conservative measures, and the patient’s activity levels are all important factors when deciding to have a knee replaced.
Progression of Arthritis/Injury
Knee replacements are normally considered for patients suffering from end-stage arthritis, otherwise known as bone-on-bone stage or severe stage. This means that the cartilage of the joint, which acts as a cushion between the bones, has worn away completely. With each movement of the knee, the bones grind together, causing pain, swelling, or even a ‘locking up’ of the knee. This bone-on-bone can also be caused by severe injury. Most surgeons will not consider knee replacement for those who are not yet at end-stage, but can offer conservative measures to help manage pain.
Reaction to Conservative Measures
Some patients have great success with mild pain-control medications. Others receive knee injections such as Depomedrol or cortisone. Others report relief from weight loss, dietary changes, or even acupuncture therapy. With knee troubles, there is no reason to consider surgery if conservative measures are working. Unlike hip replacement, which is sometimes necessary to avoid fracture, knee replacements are largely given to improve range of motion and rid the patient of severe pain and discomfort.
For injuries sometimes physical therapy can be used to minimize or relieve pain successfully.
However, it is important to note that osteoarthritis does not heal. It is a degenerative disease that grows worse over time. If the patient is at end-stage and is concerned about drug addiction, bad reactions to injections, or other negative side effects, they should speak to an orthopedic surgeon about surgical options.
If the patient is very elderly or largely sedentary, a knee replacement may not be necessary. However, for patients who are active, knee surgery may be the right option. An important factor to consider is how much activity the patient is missing in their daily life due to knee pain. Most surgeons agree that it is best to perform surgery while the patient is still strong and capable of exercising. This making recovery easier and far more successful.
In short, only the patient can decide for themselves when it’s time to have a knee replacement. When conservative measures no longer provide relief, daily activities are impacted, or the pain has simply become overwhelming and unsupportable, it may indeed be time for a knee replacement. Don’t make this decision alone though; arm yourself with knowledge. Compare orthopaedic surgeons carefully and find one to help you make this decision for yourself. It also never hurts to get a second opinion if you are still unsure.