Bone and Joint Day: Why surgery may be the best last option for knee pain

Is someone dear to you constantly complaining about nagging knee pain? Have you shown them to a doctor who may have advised a knee surgery? If the advice left you worried, you’re not alone. Every time a person, especially someone with arthritis, with excruciating knee pain is advised a surgery, a second or third opinion is sought. Many patients are still in two minds to consider knee replacement surgery for arthritic knee even though there may be enough medical evidence to suggest that Total Joint replacement is the only solution for arthritic joints.

There are about 350 million patients every year suffering with knee pain due to arthritis. It has become the second most dreaded condition after cardiovascular issues in the world. India stands at around over 15 million cases every year and this figure may touch 60 million by 2025 as per Arthritis society.

Knee replacement surgeries have evolved over the years.

“Today, a joint replacement surgeon with all his or her expertise can assure the patient of a favorable outcome and give functional ability of the implanted knee joint as good as natural knee,” says Dr Manish Samson, Senior Consultant Orthopedic and Joint Replacement Surgeon, Apollo Hospitals, Bengaluru.

According to him, knee replacement surgeries are recommended when all other treatment options – exercise, medication, dietary tweaks or use of essential oils for knee pain, are tried and exhausted. These surgeries are to make the patient functionally active without or with negligible pain. Knee replacement surgery not only takes away the pain and improves mobility of the patient, but also corrects any deformity of the patient around their knees for the rest of their life.

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Here are some frequently asked questions about surgery for knee pain

Dr Samson explains the procedure and its important, for Health Shots.

1. When is surgery recommended?

There are various reason when a doctor may suggest knee replacement surgery.

* Wear and tear in the knee joint leading to stiffness and severe knee pain that restraints a person from day to day activities including walking, running, climbing stairs and other movements.
* Pain while resting, either day or night
* Chronic inflammation of the knee due to long standing Arthritis due to medical conditions like Rheumatoid, gout or Tuberculosis and that does not improve with medicines and rest.
* Knee deformity
* Failure of non-surgical methods like medications, infra-articular injections and physiotherapy.
* Arthritis due to old fractures which have healed in a non-acceptable position.

2. What is the ideal age for an arthritic patient to undergo knee replacement surgery?

There is no fixed age for knee replacement surgery. It can be at a very young age or at geriatric age. It all depends on how badly the knees are affected. Basically, there are various disease forms of arthritis where a patient can have advanced arthritis of knee joint at young age. In such cases, knee replacement surgery is an early option. There are age-related wear and tear – what is known as osteoarthritis – that comes at very late age after 60 years.

Based on severity and failure of all other non–operative methods, knee replacement surgery is executed.

Also read: 5 common age-related pains you must not ignore

3. Can both knees be operated simultaneously?

Yes, knees can be simultaneously operated after strict medical and cardiac evaluation. The final decision is taken based on medical reports on the day prior to surgery and preferably on patients without major medical issues.

4. How fast is the recovery after knee replacement? Can a patient squat after knee replacement?

The patient can be back to normal activity in 3 to 4 weeks. Yes, the patient can squat after surgery if the patient had the ability to do so before surgery. After a period of 6 months of good self-exercise, and use of the modern implants and good surgical techniques by experienced joint replacement surgeons, patients can squat and even sit cross-legged.

5. What happens if the surgery fails?

Unfortunately, if the patient has undergone a knee replacement surgery and has problems, or if the surgery has failed over a period of time – revision knee replacement surgeries can be offered. Practically all problems can be resolved to make the patient active and pain-free again by experienced joint replacement surgeons.

6. Is the knee replacement surgery very painful? Do all patients need physiotherapy after surgery?

Yes, knee replacement surgeries were very painful. However, now orthopedic surgeons take help of pain management experts who use various intervention blocks with sustained medications to mask or block the pain, making it easy for surgeons to operate on both knees simultaneously. This also gets them the same result as from operating one knee at a time.

Regarding the post-surgery physio therapy, it varies from surgeon to surgeon and the surgical technique used. It also depends on the patient’s pre-surgery activity level and motivation status.

7. How to protect your knee replacement?

Post-surgery, the patient should abide by the following rules to protect the new knee:

* Regular light exercise to maintain strength and mobility of the new knee
* Avoid falls and injuries.
* Routine follow ups and examination of the new knee
* Treat any infection elsewhere in the body with immediate attention and antibiotics as suggested by the physicians.