For many people who suffer severe knee pain due to arthritis, medication and physical therapy are not enough. Knee replacement is sometimes necessary to relieve the discomfort and restore mobility.Surgeons conducted more than 600,000 knee arthroplasties (or knee replacements) in 2012, a dramatic increase from about 250,000 in 1999, Gretchen Reynolds reported in a New York Times “Well” blog.
However, she pointed out, recent research indicates that a large number of patients have their knee joints replaced with metal and plastic prosthetics before giving other treatments a sufficient chance to work.
Virginia Commonwealth University was the site of two studies that suggested knee replacement is advisable only in cases of advanced arthritis. The researchers said the surgery is appropriate for patients who have not only extreme pain, but also greatly limited physical ability. People at this stage can no longer climb stairs, rise from a chair or walk without assistance.Another conclusion of the research was that knee arthroplasty makes more sense for the elderly because the prosthetics typically wear out within about 20 years. Younger patients sometimes require additional knee replacements.
One of the studies involved assessing the medical records of nearly 200 people with arthritic knees who underwent knee arthroplasties. About a third of the patients suffered only minor arthritis, so they might not have been appropriate candidates for the surgery, Reynolds reported.
In the other study, the same researchers found that those with advanced, disabling arthritis enjoyed the best results from receiving knee replacements. Their knee pain subsided significantly, and they were able to regain a great deal of function.
Patients with less severe arthritis showed, on average, only about one-tenth as much improvement in knee function following surgery. “They had less room for improvement,” Daniel Riddle, a professor of physical therapy and orthopedic surgery who led the studies, told the Times.He recommended losing weight and working with a physical therapist, rather than resorting to knee-replacement surgery, unless all the cartilage in the knee has deteriorated.
Arthroplasty “is a safe and effective procedure to relieve pain, correct leg deformity and help you resume normal activities,” according to the American Academy of Orthopaedic Surgeons. The organization reported that, since the surgical method was developed in 1968, it has evolved to the point that “total knee replacement is one of the most successful procedures in all of medicine.”
In the majority of cases, chronic knee pain and disability are caused by osteoarthritis, rheumatoid arthritis or post-traumatic arthritis.
Osteoarthritis develops over time, as the knee joint sustains wear and tear, so it is typically experienced by people 50 years of age or older. They suffer knee pain because cartilage between the joint’s bones become soft and eventually deteriorate. That results in bones rubbing on bones, triggering pain and stiffness.The disease known as rheumatoid arthritis, which features inflammation of the synovial membrane that surrounds the joint, also destroys cartilage.
Post-traumatic arthritis occurs following knee injuries.
“Fractures of the bones surrounding the knee, or tears of the knee ligaments, may damage the articular cartilage over time, causing knee pain and limiting knee function,” the AAOS explained
.If you have knee pain or have been told you have knee arthritis, call to schedule an evaluation with our nationally renowned sports medicine surgeons at Orthopedic Surgery San Diego to review your options for relief.