When Is Knee Replacement Required

Knee replacement is one of the most successful operations in medicine and has improved the lives of millions of patients. Patients often ask about the correct time to have a knee replacement. Knee replacement may be necessary once you have exhausted all options of conservatively managing knee arthritis or if your arthritis is at an extremely advanced stage which is not treatable by non-operative methods.

Conservative treatment for Knee Arthritis include Physical Therapy, Weight Loss, Steroid Injections, Anti-inflammatory Medications and other Nonoperative Treatments such as knee unloader braces, heel wedges placed in the shoe, and injections of hyaluronic acid (a gel that is injected into the knee)

Knee replacement is overall a very safe procedure. However, there are some associated risks that patients should be aware of. The biggest risks that can occur after knee replacement are infection, incomplete pain relief and stiffness. These risks are all very rare, but it is important to know that they are possible. Knowing the risks, below are reasons to consider knee replacement.

Marked Disruption of Everyday Activities – One of the main reasons to consider knee replacement is pain that markedly limits everyday activities despite all conservative methods.  For surgery to be considered, the pain should be disruptive to the activities of daily living, especially if it’s to the point that the person stays in the house more to avoid activity altogether. Inability to go up and down stairs and needing to use a cane are also signs that it might be time to consider knee replacement. Failure of anti-inflammatory medications to decrease pain and presence of bone-on-bone arthritis that is causing pain on an hourly basis are indications that it is probably time to consider knee replacement for pain relief. Many patients have trouble sleeping at night because of the pain caused by knee arthritis. Failure of anti-inflammatory medications to allow patients to sleep is another indication that it might be time to consider knee replacement.

Bone-on-Bone Arthritis – Before considering knee replacement, x-rays should show bone touching bone somewhere in the knee. Patients who have only thinning of the cartilage without bone touching bone should not undergo knee replacement surgery except in rare circumstances. Patients who do not have bone-on-bone arthritis but nonetheless undergo knee replacement surgery are much less likely to be satisfied with the knee replacement. Other pain management strategies should be considered to help with the symptoms of thinning cartilage.

Instability – Knee arthritis can cause progressive instability of the knee with which the knee becomes much looser and more unstable than the native knee. In some cases, the instability is mild. In other cases, it is substantial enough that when the knee is in a bent position, it becomes markedly unstable. The instability often is manifested as a “giving way” sensation to the knee. In severe cases, the knee instability causes the patient to fall. It is my feeling that for patients with bone-on-bone arthritis who have started to experience falls because of the knee arthritis, it is probably time to have a knee replacement to improve the stability of the knee and limit the chances of falling.

Only the patient can decide when he or she is ready for knee replacement. Knee replacement is an entirely elective procedure that can be done in the patient’s time frame. There usually is no rush to having the operation. The one exception to this is the patient who is starting to fall frequently because of an unstable knee. Patients who have knee arthritis and are starting to fall because of the knee arthritis should strongly consider surgery.

Knee replacement is an extremely successful operation that has helped millions of patients. Knowing the risks, benefits, and options will help you to be included as part of the care team and will help you to get the most out of your knees.

About Dr Chirag Patel 

Dr Chirag Patel is one of the best knee replacement surgeon in Surat, Gujarat providing Total Hip Replacement and Total Knee Replacement at Kiran Multi Super Speciality Hospital & Research Center, Nr Sumul Dairy, Surat – 395004, info@drpatelchirag.com, +91 75 74 88 77 77.

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