Is Total Knee Replacement for You? - Dr. Sachin Karkamkar

Is Total Knee Replacement for You?
When Surgery Is Recommended

There are several reasons why your doctor may recommend knee replacement surgery. People who benefit from total knee replacement often have:

A knee that has become bowed as a result of severe arthritis.

• Severe knee pain or stiffness that limits your everyday activities, including walking, climbing stairs, and getting in and out of chairs. Moderate or severe knee pain while resting, either day or night
• Chronic knee inflammation and swelling that does not improve with rest or medications
• Knee deformity — a bowing in or out of your knee
• Failure to substantially improve with other treatments such as anti-inflammatory medications, cortisone injections, lubricating injections, physical therapy, or other surgeries

Candidates for Surgery
There are no absolute age or weight restrictions for total knee replacement surgery.

Recommendations for surgery are based on a patient's pain and disability, not age. Most patients who undergo total knee replacement are age 50 to 80, but orthopaedic surgeons evaluate patients individually. Total knee replacements have been performed successfully at all ages, from the young teenager with juvenile arthritis to the elderly patient with degenerative arthritis.

Orthopaedic Evaluation

• A medical history. Your orthopedic surgeon will gather information about your general health and ask you about the extent of your knee pain and your ability to function.
• A physical examination. This will assess knee motion, stability, strength, and overall leg alignment.
• X-rays. These images help to determine the extent of damage and deformity in your knee.

Other tests. Occasionally blood tests, or advanced imaging such as a magnetic resonance imaging (MRI) scan, may be needed to determine the condition of your knee's bone and soft tissues.

(Left) In this x-ray of a normal knee, the space between the bones indicates healthy cartilage (arrow). (Right) This x-ray of an arthritic knee shows severe loss of joint space and bone spurs (arrows).

Deciding to Have Knee Replacement Surgery
Realistic Expectation: More than 90% of people who have total knee replacement surgery experience a dramatic reduction of knee pain and a significant improvement in the ability to perform common activities of daily living. Most surgeons advise against high-impact activities such as running, jogging, jumping, or other high-impact sports for the rest of your life after surgery. Realistic activities following total knee replacement include unlimited walking, swimming, golf, driving, light hiking, biking, ballroom dancing, and other low-impact sports.