Is It Time For A Knee Replacement?

If you have been suffering from debilitating knee pain for months or even years, it may be time to talk with your doctor about knee replacement surgery.

“If knee pain is starting to affect a patient’s quality of life, or if it is stopping them from doing things that they enjoy, then it may be time to consider knee replacement,” said Ryan Nixon, MD, an orthopedic surgeon with Franciscan Health Center for Hip & Knee Surgery in Mooresville, Indiana.

Symptoms of Osteoarthritis of the Knee

Most patients undergoing knee replacement surgery do so to relieve pain caused by osteoarthritis of the knee, which causes the cushioning cartilage in the knee joint to break down.

Symptoms of osteoarthritis of the knee include:

• Knee pain even when resting
• Knee stiffness or loss of flexibility
• Knee swelling
• Severe knee pain that makes walking or climbing stairs difficult

If you have these symptoms, consider talking with your doctor about treatment options to get your knee pain under control.

Treating Knee Pain Without Surgery

Your care provider will likely suggest non-surgical interventions as a first step in managing your knee pain before discussing a knee replacement.

“There are plenty of non-surgical options that can help keep the arthritis pain tolerable,” Dr. Nixon said. 

Conservative treatment options for knee pain could include resting and using heat or ice on the joint and taking over-the-counter anti-inflammatory medications like Advil or Aleve to reduce pain and inflammation.

Your provider may also recommend a series of hydrocortisone shots to help reduce joint pain. Additionally, you may be encouraged to do targeted physical therapy or add exercises at home to improve knee flexibility and combat stiffness.

When To Consider Knee Replacement Surgery

When these non-surgical treatments lose effectiveness, it may be time to consider knee replacement surgery.

"There'll be a point when you have bad enough arthritis where it's a problem in your life, and eventually it'll get to be a problem that can't be managed with medications or injections" said Joseph Maratt, MD, an independent orthopedic surgeon who chooses to practice at Franciscan Health Mooresville. "The problem with hip and knee arthritis is that the cartilage surfaces that are supposed to be super smooth surfaces get worn down, And so we have to replace it with something that's just as smooth. And so usually we're going in and removing most of the joint and putting in metal and plastic surfaces that look a lot like that joint."

Age is becoming less of a consideration for knee replacement surgery. While many patients who have knee replacements are in their 60s or older, you don’t have to put off surgery until a certain age.

“We frequently do knee replacement surgery on patients younger than 60, who perhaps had an injury that caused arthritis to develop earlier than it otherwise might have,” Dr. Nixon said.

Knee Replacement Surgery: What to Expect

Surgical procedures for knee replacement have advanced considerably in recent years – to the point that many patients can go home the same day as their knee replacement surgery.

“Many of our younger, healthier patients can do the procedure on an outpatient basis and don’t need to stay overnight in the hospital at all,” Dr. Nixon said.

To ease recovery, your physician will likely recommend only replacing one knee at a time, even if you have pain in both knees.

"We do a lot of work ahead of time to get patients ready to make sure they're medically ready, but also just prepared for what comes afterwards," Dr. Maratt said. "What used to be an operation where you'd be in the hospital for three days, now you come in on the day of, and most patients go home the same day. They're standing up, they're walking within hours of surgery and yeah, that deep inside joint pain from hip or knee arthritis, it's just gone the day of surgery." 

Recovering from knee replacement

After surgery, patients will complete roughly one week of in-home physical therapy. Then, they’ll continue therapy two to three times per week at a physical therapy clinic for three to four additional weeks.

Once physical therapy is complete, knee replacement patients can return to full physical activity.

“Following recovery, patients can bike, swim, walk, play golf, play tennis – practically any activity they may want to enjoy,” Dr. Nixon said. “The only activities we don’t recommend are high-impact activities like running.”

If you’ve been dealing with debilitating knee pain, talk with your doctor about the next steps to get your pain under control – including whether you may be a candidate for knee surgery.