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When Is The Right Time To Have Knee Replacement Surgery

Your Pain Prevents You From Doing Normal Activities Or Caring For Yourself

Total Knee Replacement – Common Questions – Is it the right time to have surgery?

If you cant get relief from other treatments, your knee pain may start interfering with your daily life.

In general, the timing of a total knee replacement is determined by the impact the knee is having on your quality of life, says Jay Lieberman, MD, chief of orthopaedic surgery at Keck Medicine and chair and professor of orthopaedic surgery at the Keck School. If conservative treatments are not working and you have significant pain while walking, you may be a good candidate for surgery.

When Is The Best Time

If you have heard that you might benefit from surgery, it is worth considering doing it sooner rather than later.

However, it may not be possible to have surgery at once. Consider the following factors when deciding on a date:

  • Will there be someone to take you to and from the hospital?
  • Will someone be able to help you with meals and other daily activities during recovery?
  • Can you get the date of your choice locally, or will you need to go further afield? If so, will you be able to return easily to the hospital for follow-up appointments?
  • Is your accommodation set up for moving around easily, or would you be better off staying with a family member for a few days?
  • Can you find someone to help with children, pets, and other dependents for the first few days?
  • How much will it cost, and how soon can you get the funding?
  • Can you get time off work for the dates you need?
  • Will the date fit in with your caregivers schedule?
  • Will the surgeon or doctor be around for follow up, or will they be going on vacation soon after?
  • Is it best to choose the summer, when you can wear lighter clothes for comfort during recovery?
  • Depending on where you live, there may also be a risk of ice and snow in winter. This can make it hard to get out for exercise.

You may need to spend 13 days in the hospital after surgery, and it can take 6 weeks to get back to normal activities. Most people can drive again after 36 weeks.

It is worth considering these points when deciding on the best time to go ahead.

Can Rehabilitation Be Done At Home

All patients are given a set of home exercises to do between supervised physical therapy sessions and the home exercises make up an important part of the recovery process. However, supervised therapy–which is best done in an outpatient physical therapy studio–is extremely helpful and those patients who are able to attend outpatient therapy are encouraged to do so.

For patients who are unable to attend outpatient physical therapy, home physical therapy is arranged.

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What Are The Risks Of Having Knee Replacement Surgery Too Soon

The average age of someone who gets a knee replacement is about 70 years old. However, some people decide to get knee replacement surgery as young as 50.

There are several reasons younger people may opt for a knee replacement, particularly those who are extremely active or athletes. If youre young and considering a knee replacement, here are a couple things to know:

  • Your implant can wear out prematurely. If youre in your 40s or 50s, youre likely living a more active life than someone in their 60s or 70s. More activity, means more wear and tear on the joint implant, which can cause it to wear out more quickly than expected. And that means pain, stiffness and mobility issues can return.
  • Knee replacements dont last forever and you may need another surgery. Many patients have knee replacements that last for 20 years or more. But the longer and harder you use your replacement joint, the more likely it becomes that youll need a second knee replacement surgery to replace a worn out implant. And of course, knee replacement surgery carries some risks, especially as you age.

You Have Bad Arthritis

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Most people who undergo a knee replacement have either osteoarthritis, the wear-and-tear type of arthritis rheumatoid arthritis, an autoimmune condition that causes joint pain and damage or post-injury arthritis.

Osteoarthritis, rheumatoid arthritis and posttraumatic arthritis affect the knee through different mechanisms, however, these different conditions are similar in that they all result in loss of cartilage, which causes pain and loss of motion, says Nathanael Heckmann, MD, an orthopaedic surgeon at Keck Medicine of USC and an assistant professor of clinical orthopaedic surgery at the Keck School of Medicine of USC. When these symptoms become severe, knee replacement surgery may provide considerable symptom relief by replacing the worn-out surfaces of the knee.

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Why Revisions Are More Complex

Revision replacement is difficult for several reasons. First, when someone has surgery, scar tissue develops, and soft tissues become less identifiable. Performing the second surgery is always more difficult. Second, when performing a knee replacement, bone is removed. When performing a revision knee, often more bone has to be removed, and some may be lost as a result of the problem with the implant. Maintaining adequate bone to support the new implant can be a challenge. Finally, obtaining a knee that is flexible enough to allow for motion, yet stable enough to keep you steady, is also more difficult in revision situations.

When A Knee Replacement Is Needed

The usual reason that someone has a knee replacement is because they have very painful arthritis in their knee.

You should always bear in mind that a knee replacement is a major operation and you should really only be considering it when you have run out of other options. A doctor can tell you that you have arthritis in your knee and they can tell you that you could have a knee replacement but only you can decide if the time is right for you. Most people who decide to have a knee replacement are already taking painkillers every day but are still not able to walk far and need to use a stick.

Looking at all of the research on knee replacements , it would seem that the people who do best after a knee replacement are the ones with severe arthritis but not so bad that the joint is completely destroyed. This could be because it’s really important to have strong muscles around the knee in order to make the best recovery and people who have the most advanced disease tend to have very weak leg muscles.

Symptoms will often vary from day to day for no apparent reason. This is really common. Some people think their symptoms vary according to the weather or according to how much they have been doing – but it can be completely random.

Sometimes you will be aware of a grating or grinding feeling coming from your knee. This is called crepitus. On its own this does not necessarily indicate a serious problem with your knee.

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Providing Better After Care For Patients

We’re funding research which aims to provide a standardised approach and assessment for virtual clinic follow-up of total joint replacement patients and subsequent management of patients identified as ‘at risk’ by this approach. This study would enable us to deliver better and more streamlined after care for patients.

Who Might Need A Knee Replacement

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Knee surgery may be suitable for patients who experience:

  • Severe knee pain or stiffness that prevents them from carrying out everyday tasks and activities, such as walking, going upstairs, getting in and out of cars, getting up from a chair
  • Moderate but continuous knee pain that continues while sleeping or resting
  • Chronic knee inflammation and swelling that does not improve after taking medications or resting
  • Knee deformity, where there is a noticeable arch on the inside or outside of the knee
  • Depression, resulting from an inability to carry out daily or social activities

If the other available treatment options have not worked, surgery may be the best option.

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The Surgical Sweet Spot: Do You Know When Its Time For Knee Replacement Surgery

Its the million dollar question: When is the best time for knee replacement surgery?

Youve been managing your knee pain with more conservative treatment options for some time and they may not be working like they used to. But at what point to do you consider surgery?

Good timing is key to helping you maximize how youll benefit from the procedure. But for many, stretching the replacement timeline out as much as possible is very common. In fact, many of our knee replacement patients tell us that they wish they hadnt waited so long.

How can you find the knee replacement sweet spot? Below we cover some of the key factors in determining if its time for knee replacement surgery, as well as the risks of delaying knee replacement surgery or having it too early.

What Experts Say About The Best Month For Tkr Surgery

I tried hard to find expert opinions for the best time of the year for TKR. Unfortunately, I could not find any. Im not a doctor but hopefully, my information can help you decide on the best time of year .

Depending on your need for knee replacement, you may not have the luxury of picking a time of year and might proceed with the surgery based on your doctors recommendation.

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Your Knee Has Become Deformed

If your arthritis is advanced, it can affect the way you walk, which can also lead to further problems elsewhere in your body.

As arthritis progresses, the knee may become bowed or knock-kneed, Heckmann says. If this type of deformity develops over time, a knee replacement may be indicated.

In addition, people with arthritis may also lose the ability to straighten their knee, according to Heckmann. If this occurs, you should seek an evaluation with an orthopaedic surgeon, as this loss of motion may be permanent, even after the knee has been replaced, he adds.

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Knee Replacement Recovery Tips

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Here’s some top tips for four common questions about total knee replacement recovery time:

  • How Long Does The Pain Last? Many people find they have less pain after their knee replacement as the arthritis pain is no longer there. The post-op pain usually settles down within 6-12 weeks although their may be some residual pain and swelling for up to a year
  • How Do I Sleep After A Knee Replacement? Typically people find it most comfy to sleep on a firm mattress, either lying on their back or on their side with a pillow between their legs
  • Can I Kneel Down With My Knee Replacement? Yes you can although it may be uncomfortable in which case use a cushion or knee pad. Kneeling won’t cause any damage to the knee replacement
  • How Do I Make the Best Recovery? In order to make the best knee replacement recovery, follow all the advice from your doctor and physical therapist. Start exercises prior to surgery, get up and about as soon as possible, stick to your rehab programme, take medications reguarly when advised and keep going. There may be ups and downs along the way, but stay focused and positive
  • You can find the answers to loads more similar questions in the total knee replacement recovery questions section.

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    What Is The Right Age To Have 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.

    Nonsurgical Treatments Are No Longer Effective

    If you have arthritis of the knee, youll probably start with more conservative measures such as medications, steroid injections or physical therapy to alleviate your symptoms. But at some point, they may not be enough.

    Anti-inflammatories, injections and physical therapy are temporary measures to provide pain relief, but they dont reverse the underlying cause of pain and dont allow cartilage to regenerate, Heckmann says. As time passes, these arthritic conditions tend to progress in severity, rendering these types of treatments less and less effective.

    At that point, surgery may be an option.

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    Helping Patients To Make Informed Decisions

    We’re funding research to improve patient experience before, during and after knee replacement surgery. This includes a project based at the University of Sheffield which aims to help patients make informed decisions about their surgery. The research team will use the UK National Joint Registry dataset to develop and validate a personalised, web-based decision aid to help patients considering knee joint replacement to make informed choices about their treatment.

    Extending The Life Of Your Knee Implant

    Knee Replacement Surgery

    Currently, more than 90% of modern total knee replacements are still functioning well 15 years after the surgery. Following your orthopaedic surgeon’s instructions after surgery and taking care to protect your knee replacement and your general health are important ways you can contribute to the final success of your surgery.

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    What Is A Total Knee Replacement

    Total knee replacement is a type of surgery to replace a damaged knee joint. A minimally invasive surgery uses a smaller cut than a traditional total knee replacement. This type of surgery typically requires special tools so that the surgery team can see and do the procedure through the smaller incision.

    The knee has several parts: the lower end of the thigh bone , the upper end of the shin bone , and the kneecap . A smooth substance called cartilage caps the ends of these bones and keeps the bones from grinding together. When there is damage to the knee joint, these bones may scrape together abnormally and cause pain.

    During minimally invasive total knee replacement, your surgeon makes an incision to access your shinbone and thigh bone. Next, he or she removes a portion of the bones that make up the knee joint. Your surgeon replaces these bone parts with metal components that recreate the joint surface. A layer of plastic is placed between the metal components for smooth gliding.

    Minimally invasive total knee replacement often takes place under general or spinal anesthesia.

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    How Do I Know If A Knee Replacement Is Right For Me

    Chronic knee pain isnt normal. If you experience constant pain, you should talk to your doctor. They may recommend X-rays to confirm bone deformities or deterioration, and an MRI to diagnose issues with soft tissue.Though total knee replacements are typically a very successful surgery, its important to recognize the potential risks and drawbacks for certain patients, said Dr. Doherty. I encourage patients to speak openly about pain levels and physical limitations with their doctor to confirm your best treatment options.John Doherty, MD, is an orthopaedic surgeon specializing in hip and knee surgeries at Geisinger Orthopaedics and Sports Medicine in Scranton. To schedule an appointment, call 800-275-6401.

    Geisinger Health Plan may refer collectively to Geisinger Health Plan, Geisinger Quality Options Inc., and Geisinger Indemnity Insurance Company, unless otherwise noted. Geisinger Gold Medicare Advantage HMO, PPO, and HMO D-SNP plans are offered by Geisinger Health Plan/Geisinger Indemnity Insurance Company, health plans with a Medicare contract. Continued enrollment in Geisinger Gold depends on annual contract renewal. Geisinger Health Plan Kids and Geisinger Health Plan Family are offered by Geisinger Health Plan in conjunction with the Pennsylvania Department of Human Services . Geisinger Health Plan is part of Geisinger, an integrated health care delivery and coverage organization.

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    Why You Might Say Nows The Time

    Here are seven signs that the time might be right for a knee replacement:

  • Medicationseven stronger anti-inflammatory drugsdon’t help, or no longer help ease your pain.
  • Other less invasive treatment options dont effectively reduce your and inflammation. These may include cortisone injections, lubricating injections, rest, and .
  • You have lots of difficulty and pain performing everyday tasks, such dressing, bathing, getting out of bed or a chair, or climbing stairs.
  • You need the aid of a cane or walker to get around.
  • Your pain is severe day and night. The pain is there even when youre not using your knee, such as when youre sitting still or lying down.
  • Your knee has become deformed from injury or . It bows in or out.
  • You are between 50 and 80 years old. Most people who get knees replaced are in this age range.
  • Nerve And Other Tissue Damage

    The Importance of Timing in Knee Replacement Surgery

    There’s a small risk that the ligaments, arteries or nerves will be damaged during surgery.

    • Fewer than 1 in 100 patients have nerve damage and this usually improves gradually in time.
    • About 1 in 100 have some ligament damage this is either repaired during the operation or protected by a brace while it heals.
    • About 1 in 1,000 suffer damage to arteries that usually needs further surgery to repair.
    • In about 1 in 5,000 cases blood flow in the muscles around the new joint is reduced . This usually also needs surgery to correct the problem.

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    Risks Of The Procedure

    As with any surgical procedure, complications can occur. Some possiblecomplications may include, but are not limited to, the following:

    • Bleeding

    • Blood clots in the legs or lungs

    • Loosening or wearing out of the prosthesis

    • Fracture

    • Continued pain or stiffness

    The replacement knee joint may become loose, be dislodged, or may not workthe way it was intended. The joint may have to be replaced again in thefuture.

    Nerves or blood vessels in the area of surgery may be injured, resulting inweakness or numbness. The joint pain may not be relieved by surgery.

    There may be other risks depending on your specific medical condition. Besure to discuss any concerns with your doctor prior to the procedure.

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