When is it time for a knee replacement?


When is it time for a knee replacement?

If routine movements such as getting out of a chair, climbing stairs or walking to the kitchen for a snack are causing knee pain, you may wonder whether your symptoms are simply a natural part of aging or caused by an underlying condition.
In truth, it could a little bit of both. Many people have knee pain as a result of osteoarthritis, a degenerative condition that can cause the cartilage surrounding the knee joint to break down. The condition is most common in people over 50, but younger people can experience osteoarthritis, too.
As osteoarthritis advances, there’s less cartilage to cushion the joint. Without protection, the bones that make up the knee joint rub together when you move. Over time, even the simplest movements can cause pain.


While there are a variety of ways to alleviate the pain caused by osteoarthritis, many patients will ultimately opt for knee replacement surgery as a permanent solution. In fact, it’s one of the most common surgeries in the U.S. Surgeons perform an estimated 600,000 knee replacements every year, and that number is expected to increase significantly by 2030.
As with any surgery, a knee replacement comes with inherent risks, and the recovery can be lengthy. But the payoff is worth it for many patients, says Dr. Mark Rowley, an orthopedic surgeon who practices at Tidelands Health Orthopedics at The Market Common. 

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Even so, knowing when the time is right to have knee replacement surgery isn’t always clear cut. Instead of immediately pursuing surgery to correct knee pain, Dr. Rowley says the best approach is more holistic.
Weight management, low-impact exercise, anti-inflammatory pain relievers and bracing are good places to start, he says.
“The biggest factor for knee arthritis is body weight,” he says. “Therefore, physical therapy can be helpful in the short term if a patient needs to lose weight or build strength and stamina.
“Physical therapy can serve as a bridge for an individual who hasn’t exercised in the past,” he says.

Everyone is different

Rowley says there’s no magical age when you should have a knee replacement. Instead, consider your physiological age rather than your chronological age.
“Some patients are very active, even as they reach an advanced age,” he says. “It’s important to look at your overall activity level and not your age in numbers.”
If your normal activity levels or your ability to work or perform activities of daily living is impacted by your knee pain, it’s time to talk to your physician about total knee replacement surgery.
“If the knee pain can be managed with activity modifications, medications or orthotics, it’s best to treat it non-operatively,” he says. “If not, it’s time to have a discussion about knee replacement surgery.”
Today’s joint replacements typical last 20-25 years, Dr. Rowley says, so replacement is a viable option for younger patients with joint deterioration, especially those who work in physically demanding occupations.


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