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Knee Replacements: When Do You Need One & What You Should Know?

June 11th, 2020 3:24pm

Knee replacement is generally a last resort option, but if you have constant pain or are severely limited, it might be a necessity. The good news is that knee replacement surgeries are very common and have been proven highly successful in relieving pain and other debilitating symptoms. 

There are several reasons for getting knee replacement surgery, as painful or functionally limited knees are often a symptom of an underlying issue. Because of this, you should always consult with a orthopaedic surgeon for a reliable diagnosis and recommendation on next steps.

If you have consulted with an orthopaedist and have been told that a knee replacement is indeed the recommended next step, read below to learn more about what you should consider before moving forward.

 

Types of Knee Replacement

Joint pain is usually an indication of joint inflammation which is a common symptom of many diseases and conditions. The inflammation might be temporary, recurring or consistently present depending on the trigger.

Here are a few examples of possible causes for joint problems in the knee that might warrant a medical intervention. 

 

Arthritis 

Arthritis is a common umbrella term for conditions that cause joint inflammation - rheumatoid arthritis and osteoarthritis are the most commonly known examples. A lesser known condition is gout, which is caused by uric acid build up near joints. Severe cases of arthritis can be very painful, limit mobility, and decrease quality of life dramatically.

 

Knee Injuries 

Knee injuries are common, especially among athletes. A sports injury or other type of injury affecting the knee can create lasting damage. Examples of this are tendonitis, bursitis, a meniscus tear or dislocation. Depending on the type and severity of the injury, surgery might be needed to repair the damage or relieve the symptoms.

 

Knee Malalignment 

Knee malalignment can either be varus (bowlegged) or valgus (knock-kneed). In adults, malalignment is caused by diseases like rheumatoid arthritis or by injury. While there are treatment options to explore before going to joint replacement surgery, it may be the only way to prevent the condition from getting worse.


When to Consider Knee Replacement

As mentioned, knee replacement is a last resort treatment option and often only advised when alternative treatments such as injections, pain medication, weight loss and/or physical therapy are not successful. However, it is a very common surgery and highly effective in resolving chronic pain and increasing quality of life.  In 2011, more than 650,000 total knee replacements were performed in the United States.

The following are possible reasons for getting knee replacement surgery when other treatments have proven to be insufficient.

 

Chronic Untreatable Pain

Pain management is not always effective with certain chronic conditions. When the pain is not reduced by alternative treatments there might be cause for a total knee replacement (TKR). According to the Arthritis Foundation, 90% - 95% of TKR surgeries are a successful pain relief measure in younger patients.

 

Pain When Resting

Certain conditions cause knee pain even when sitting down or lying down. In such extreme cases physical therapy might not be enough. Often patients will complain of not being able to get a full night’s sleep as a result of the knee pain.

 

Limited Mobility

Knee replacement surgery is often done to preserve a patient’s quality of life by restoring function.  When the joint problem is debilitating and considerably limiting a patient’s ability to perform their daily life tasks or hobbies, TKR could be the solution.

 

Constant Stiffness & Swelling

Linked to limited mobility is constant stiffness and swelling. There are many possible underlying causes for this. Knee replacement surgery might solve these symptoms because it involves the removal of affected tissue.

 

Long Term Conditions

If the condition causes recurring periods of extreme pain, a long term solution is needed. The average lifespan of a knee replacement is 15 - 20 years depending on the use of the knee and the person’s general health.  However, with implant advancements and surgical techniques, many surgeons believe the knee replacement life space could be 25+ years. That is why younger patients might benefit the most.

 

Lasting Effects from Knee Injury

A knee injury may have lasting effects and could even cause deformities. A knee replacement can repair these deformities so that it does not affect the person’s quality of life.

 

Deformities

There are disorders and diseases that cause deformities in joints. When the deformity remains, even after treating the underlying factors, surgery might be an important part of the treatment.

 

High Activity Level

Athletes and other highly active people are considerably affected by knee pain. Again, doctors may suggest knee replacement to preserve the person’s quality of life so that you can get back to doing the things you love.


Before and After Knee Replacement Surgery

Chances are that the surgeon prescribes physical therapy before the surgery. This is to strengthen the muscles around the knee and, in some cases, manage the symptoms during the time running up to the surgery.

Some patients may also be assigned a diet and exercise regimen to promote weight loss and promote healthy eating habits. Depending on the underlying cause and the patient’s health, reaching a healthier weight may make the surgery more successful.

After the knee replacement surgery a period of rehabilitation starts. This is usually guided by a physical therapist. It involves exercises to improve mobility, conditioning and strength.

Besides physical therapy, the patient might be prescribed pain medication to manage post-surgery pain. This is usually for a shorter time period and right after the surgery takes place.

 

What to Expect from Knee Replacement

Although knee replacement is successful in reducing pain and symptoms, it is not a solution on its own. For an effective knee replacement the patient must remain committed to the pre- and post-operative care. 

It is extremely important to keep up with general health before (and especially after) the surgery. Maintaining a healthy lifestyle will help speed up the healing process and lead to a much better post-op quality of life overall. 

A final consideration is that knee replacement may creates scar tissue and scar tissue is less flexible than a person’s regular ligaments. Thus, the patient might experience some limitation in movement. However, in many cases patients regain full knee functionality, and relieve the chronic pain.




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