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Can You Wait Too Long For Knee Replacement

Things No One Ever Tells You About Getting A Knee Replacement

Can you wait too long before knee replacement surgery?

Heres what you need to know thats not in the brochure: 1. You might not be a good candidate.A study published last year by researchers from Virginia Commonwealth University in Richmond questioned the value of knee replacement for some of the people rushing to get it. After analyzing data from a large study of men and women who had the operation, the researchers found that fully one-third of them were not actually good candidates for the surgery, which is why they got only a very modest benefita 2-point improvement on a common measure of knee function, compared with a 20-point improvement for people who started out with really bad knees.

“Pain that doesnt go away and moderate to severe arthritis are necessary for a knee replacement to do its job,” Lajam says. “If you have the surgery, but its actually a problem of nerve pain, hip pain, or circulation, its not going to help you.” The advice here is not to wait until your knees are completely destroyed before seeking surgery, but to make sure that youve tried other measures first and that you meet both criteriaconsistent pain and advanced arthritis.

It Could Lead To Complications During And After Surgery

Because dealing with chronic pain and reduced mobility can take a toll on your physical and emotional health, delaying your surgery could lead to additional complications during and after your knee replacement. If you experience weight gain, low endurance, or get diagnosed with a cardiac condition or similar ailment, you may require a more complex procedure and longer estimated recovery time.

Remember: as the joint deteriorates, the overall replacement process will become more complex as the surgeon must navigate increased joint deformity while operating on someone with suboptimal health. This means that your surgery may take longer and leads to a higher risk of postoperative concerns like blood clots, infections, or obstacles to recovery.

Additionally, most patients experiencing late- to end-stage osteoarthritis are older individuals. Old age is associated with an increased risk of surgical complications and slower recovery times.

Does My Age Impact How Long Knee Replacements Last

Over 90% of knee replacements last at least 10 years and over 80% of knee replacements last 20 years. For people over 70, there is only a 5% chance that they will need to have another surgery to have their knee replacement revised in their lifetime. A revision is when the knee replacement fails or wears and the surgeon goes back in and replaces all or part of the knee replacement. But what about people younger than 70?

For people under 70, it is much more likely that they will need a revision. About 35% of men and 20% of women between the ages of 50 and 54 who have a knee replacement will require at least one revision in their lifetime. The percentage of people who need a replacement continues to decrease with increased age, and the difference between males and females also disappears with increased age. This is not only because people in their 50s are expected to live longer than people over 70, but also because younger age seems to lead to the replacement lasting a shorter length of time. But this does not mean that people under 70 will not benefit from knee replacements or that they should not get knee replacements they will still have improvements in the ease of their day-to-day activities and decreased pain as a result of the knee replacement.

Image from Britton-Jones, C. A. . Prehabilitation. British Journal of Hospital Medicine, 78, 729-729.

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Why Some Numbers Are Not Available

If you see sections that say no data, there could be a few reasons why, such as:

  • the number of patients treated is too low to report
  • the service isnt available at the hospital youve selected
  • there were no patients treated during the reporting period
  • the facility is new to reporting and has just started collecting data

See the full list of reasons why some data might not be available.

The Drawbacks Of Waiting To Have Knee Replacement Surgery

Most people wait too long for knee replacement surgery ...

When you wait to have knee replacement surgery, youre not just putting off an unpleasant experience. Youre dealing with chronic knee pain for longer. The pain and stiffness often cause patients to become less active, which can result in weight gain and even more pain.

As youre dealing with it longer, your health and wellness tend to be going downhill as well, Dr. Hansen said. By the time you have the surgery, youre older, less active, less healthy, in more pain, with less function. Its not a good mix.

The knee replacement surgery itself can be more complicated in patients who have waited longer than recommended. More damage and inflammation can translate to a longer surgical time, with a higher risk of complications after surgery, such as blood clots or infection. Even with a completely successful surgery, patients who waited to have knee replacement surgery tend to have lower function and higher rates of dissatisfaction with their surgeries.

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Youll Experience More Pain And/or Find Yourself Increasingly Unable To Manage Your Pain

This is a simple, but crucial, point. While many people may want to delay their surgery because its an unpleasant experience or they dont want to undergo a lengthy recovery, these delays may ultimately lead to more complications down the line. It also means youll be dealing for chronic pain for longer, which will affect your quality of life. Dont let your health and wellness go downhill by waiting too long to undergo a joint replacement surgery. Instead, be proactive and consult your doctor or orthopedic surgeon about your options and create a plan that will get you back on your feet.

Final Thoughts

Knee replacement is one of the most successful surgical procedures. Its a proven method to alleviate pain and help improve mobility and relief from osteoarthritis. More than 700,000 knee replacement surgeries happen every year. We encourage you to monitor the state of your knee pain and talk to your doctor about whether or not youre at a stage where you should be considering a joint replacement.

Here are some of the conditions we treat:

  • Knee Replacement

Can An Objective Algorithm Work

Not everyone believes that such an objective approach will succeed in the health care environment.

“I would say this paper looks at the issue from the perspective of the experts and not necessarily from a patient perspective,” said Dr. Bart Ferket, an assistant professor of population health science and policy at the Icahn School of Medicine at Mount Sinai Hospital in New York City.

“It’s an attempt to objectify things that are subjective,” said Mount Sinai orthopedic surgeon Dr. Edward Adler, who, like Ferket, was not involved in the study.

Pain, for example, is subjective and could interfere with the algorithm’s ability to assess knee stability and a patient’s reported levels of pain.

“Some people will allow you to move their knee even though their knee hurts a lot,” Adler said. “They can have a lot of pain, you wouldn’t know it. They function well.

“There are other people who have a little bit of pain and everybody around them has to know about it,” he added. “So it’s fairly subjective as to how much you tolerate before you get your knee replaced.”

Ghomrawi agrees there could be excellent subjective reasons why a person might decide to get an early knee transplant instead of deciding to wait.

Or perhaps an older person has a very painful knee, “but they’re bearing with it because they’re taking care of their spouse,” Ghomrawi said.

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Knee Replacement Surgery Isnt Typically Recommended If Youre Younger Than 50

Recommendations for surgery are based on a patients level of pain and disability. Most patients who undergo a total knee replacement are age 50-80. This is because, knee replacements are not as durable as your own knee and eventually wear out. On average, a total knee replacement lasts about 15-20 years. So if you have the procedure in your 40s, youll likely need another or revision surgery later in life. Whats worse than having to go through another surgery, is that the second surgery is much harder than the first.

The goal of the second knee replacement surgery is the same as the first to relieve pain and improve function. However, revision surgery is a longer, more complex procedure that requires extensive planning, specialized implants and tools, prolonged operating times, and mastery of difficult surgical techniques. Youll also be older and less resilient when you need the second surgery which is why doctors dont usually recommend knee replacement for younger patients.

Knee Arthritis Is A Progressive Disorder Leading To Greater Damage With Time The Surface Of The Joint Continually Keeps Getting Abraded And Bone Loss Occurs From The Surfaces

Knee Replacement: Why Most Wait Too Long to Have It Done.

Studies have shown that patients often wait far too long before doing a knee replacement. A study published in the Journal of Bone and Joint Surgery found that a vast majority of patients who would benefit from knee replacement are taking too long to have surgery, to the detriment of their mobility and overall health. The study also showed that delayed knee surgery has negative effects on postoperative recovery. During the COVID-19 pandemic, many patients delayed addressing their joint and bone problems this in turn proved to be even more detrimental. In this article, Dr Kaushal Malhan, Director-Orthopedic Surgery, Fortis Hospital, Mulund, shares what according to experts is the right time to undergo knee replacement surgery.

Knee Arthritis is a progressive disorder leading to greater damage with time. The surface of the joint continually keeps getting abraded and bone loss occurs from the surfaces. This results in increasing deformity. There is abnormal stress on the ligaments which will gradually stretch out and lead to instability of the joint. The deformities get progressively tighter and fixed resulting in unstable and abnormal gait patterns. Muscles and bones get weaker due to disuse. Adjacent joints like the spine, hip and ankle suffer damage due to abnormal strain.

The ideal time for surgery will vary from person to person, but some pointers help in decision making.

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What Is Knee Replacement Surgery

If you and your doctor have already tried all other knee pain and injury treatments, an orthopedic surgeon may eventually recommend knee replacement. This surgery involves removing all or certain parts of the knee joint. The orthopedic surgeon will then replace the removed knee joint with an artificial one, which is made of plastic and metal.

Knee Replacement Surgery At Logansport Memorial Hospital

The best patient care starts with doctors who listen with compassion. At Logansport Memorial Hospital, our orthopedic care team knows how scary getting a knee replacement can be.

Whether you need an initial diagnosis, a second opinion, or follow-up care, we will take the time to answer your questions about what joint replacement surgery might mean for your overall health.

If youre thinking of getting knee surgery or want to talk through your options for getting back on your feet, were here for you.

to schedule an appointment with one of our orthopedic surgeons to discuss your knee condition and learn more about knee replacement surgery.

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What To Consider Before Total Joint Replacement

There is no one-size-fits-all approach to hip or knee replacement, says Dr. Piuzzi. The surgical team will personalize the surgery for you. And you need to weigh the benefits and risks of having the surgery.

Before undergoing hip or knee replacement surgery, you and your healthcare provider should discuss the following.

Your overall health

Having a chronic condition doesnt exclude you from hip or knee replacement. But your medical team should consider any conditions before you move forward. For instance, if you have:

  • Diabetes: You may need a test to ensure your blood sugar is under control.
  • Heart condition: Your orthopedic surgeon may work with a cardiologist during surgery and recovery.

Medications you take

If you take prescription or over-the-counter medications or supplements, your surgeon needs to know. You may need to stop taking them several days before surgery.

Muscle strength

Recovery from total joint replacement takes work. You have to complete specific exercises and follow a physical therapy plan. But you dont need to be in peak physical condition to get a new hip or knee. Your doctor will just want to ensure you have enough strength to successfully recover from surgery.

Family and social support

Other pain relief options

Not everyone who has OA needs joint replacement surgery. Your orthopedic surgeon may recommend these options before deciding on surgery:

When To Delay Knee Replacement Surgery

Flying After A Total Knee Replacement

Knee replacement surgery is the last resort when all other options have failed to improve the symptoms. The consideration for surgery is based on the severity of symptoms.

If non-surgical interventionssuch as losing weight, taking medications, doing physical therapy, and using assistive deviceshave improved the symptoms and quality of life, knee replacement surgery may not be needed yet.

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This Common Procedure Can Help Reduce Pain And Restore Your Ability To Move Better But How Do You Know When Its Time For Surgery

Knee replacement surgery is one of the most successful procedures in all of medicine, according to the American Academy of Orthopaedic Surgery . Its also very common: Over 790,000 knee replacements are performed each year in the United States. A complete knee replacement more correctly, a resurfacing places metal pieces to recreate the surface of the joint, with a plastic separator in between and possibly a plastic resurfacing of the inside of the kneecap .

Although youll need a little help afterward, you should be able to begin walking again either the same day or the day after surgery. And the procedure is overwhelmingly successful: The AAOS estimates that 90% of modern total knee replacements are still working more than 15 years after surgery.

How do you know if you need a knee replacement in the first place? Deciding when its time is a personal decision between you and your doctor, but there are some factors that make you a more likely candidate for surgery.

Preparing For Knee Replacement Surgery

Before you go into hospital, find out as much as you can about what’s involved in your operation. Your hospital should provide written information or videos.

Stay as active as you can. Strengthening the muscles around your knee will aid your recovery. If you can, continue to do gentle exercise, such as walking and swimming, in the weeks and months before your operation. You can be referred to a physiotherapist, who will give you helpful exercises.

Read about preparing for surgery, including information on travel arrangements, what to bring with you and attending a pre-operative assessment.

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Most People Wait Too Long For Knee Replacement Surgery Study Says

Living with knee pain? A new study has found that 90% of Americans with osteoarthritis suffer too long before having a knee replacement that could improve th…

Living with knee pain? A new study has found that 90% of Americans with osteoarthritis suffer too long before having a knee replacement that could improve their quality of life.

“When people wait too long, they lose more and more function and can’t exercise or be active, thus leaving them open to weight gain, depression and other health problems,” said lead investigator Hassan Ghomrawi, associate professor of surgery at Northwestern University’s Feinberg School of Medicine.

In addition, the surgery may not be as successful, Ghomrawi said.

“There are multiple studies that have shown that patients who do surgery when their function is very deteriorated may improve quite a bit, but their improvement is still not to the average,” Ghomrawi said. “They lag behind in optimal benefit.”

On the flip side, the study also found that 25% of people who do choose knee surgery are getting it too early, running significant risks, including potential complications, while incurring the cost of major surgery potentially without getting much extra benefit in mobility.

“There are a million knee surgery procedures occurring in the United States each year,” Ghomrawi said, “and 25% of those are premature. That’s a lot of patients.”

What Is The Right Age To Have A Knee Replacement

How long should I wait before having a Knee Replacement?

Knee replacement surgery, also called knee arthroplasty, is a common surgery to remove the damaged cartilage weight-bearing surfaces of a worn-out knee and replace the joint with a prosthetic made of metal and plastic. But, what is the best age to have a knee replacement surgery?

The general rule of thumb a few years ago was that anyone under the age of 70 was too young for knee replacement surgery, but that thinking has changed.

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When To Wait When To Rush

From my experience, most adults wait too long to have a knee surgery specifically replacement, said Morgan Nolte, a geriatric physical therapist from Nebraska. The older someone is, the more likely they have multiple co-existing health conditions, such as high blood pressure or diabetes, and those can complicate recovery.

Lean muscle mass also declines with age, so the physical effort of recovery can seem harder than if the surgery was performed a bit earlier in life, she told Healthline.

Many patients who undergo a knee surgery have reported to me they wished they would have got it earlier for a faster recovery, but also to enjoy more years with less pain, she added.

Dr. Seth S. Leopold, an orthopedic surgeon, professor at the University of Washington and editor-in-chief of the journal Clinical Orthopedics and Related Research, said he would take the findings with a large lump of salt.

Both what I see in practice as a high-volume joint replacement surgeon and as the editor of an orthopedic surgery journal suggests to me that if anything, surgeons recommend knee replacement too easily and too often, he said.

The recovery may be slower or less complete if someone waits too long, but thats only the case if they wait way too long, he said.

Patients and doctors should first look at nonsurgical interventions to attempt managing symptoms.

Only if they cant, and only if the pain and limitations are pretty severe, does joint replacement make sense to me, he noted.

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