In the United States, almost 1 million knee replacements are performed each year.  That number is expected to continue increasing through 2030.  Simply put, knee replacements are becoming common place. 

But is a knee replacement the right thing for you? If so, when?

A recently published study out of Northwestern University’s School of Medicine in Chicago indicates that the timing of a knee replacement is absolutely crucial for success (Ghomrawi et al. 2020).  Of patients in the study who could benefit from knee replacement, 91% waited too long.  On the flip side, 26% of patients who didn’t need a knee replacement, underwent the surgery anyway.  

What indicates that someone has waited too long to have a knee replacement?

They lose the ability to walk and move around well.  As a result, they become more sedentary.  Sedentary people develop cardiovascular and other health issues.  With a decline in overall health and the ability to engage in life’s activities, depression tends to creep in as well.  When someone goes into knee surgery in poor physical health, rehabilitation is more challenging and the outcome is subpar.  Walking and moving around are still difficult—even after the knee replacement. 

What happens when someone has a knee replacement too early?

A person has a major surgery, taking risk unnecessarily.  They may also need to have another knee surgery in the future.  And the second surgery will likely be more challenging than the original surgery.  

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When is the right time to have a knee replacement?

Surgeons are developing more strict criteria for deciding who should pursue knee replacement.  Multiple factors are taken into consideration including: pain, joint function, age and X-ray assessment.  Xray assessment should show absence or near absence of cartilage in at least one compartment of the knee.  In other words, significant degenerative joint disease.  

 Another factor, is the patient’s expectations.  If pain levels are low to moderate a patient is less likely to appreciate a new knee as much as if their pain levels have been relatively high.  The more drastic the reduction in symptoms, the greater positivity the patient will have mentally and physically.  

If you are not quite ready to have a knee replacement, but are beginning to lose your ability to walk and move around well, consider consulting a physical therapist.  Strengthening the muscles around the knee with specific exercises can sometimes go a long way in increasing function and putting off that knee surgery to a time when it is appropriate and most beneficial.  And after you finally do have that knee replacement, your physical therapist would love to assist you in maximizing your mobility and strength.   

Reference:

Ghomrawi et al. 2020.  Examining the timeliness of total knee replacement among patients with knee osteoarthritis in the U.S.  The journal of Bone and Joint Surgery. 102(6):468: 10.2106/JBJS.19.00432