Will Knee Replacement Help Arthritis

Recovering From Knee Replacement Surgery

For the majority of people knee replacements are very successful. There is a lot of evidence from research showing that patients have less pain and are much more mobile after surgery and this often greatly improves their quality of life. Outcomes are getting better too, as more research is carried out on what the best operation is and how to reduce the risk of complications.

However about 8 people out of 100 are unhappy with their knee replacement 2-17 years later. If they have had to have their knee replaced a second time , they are twice as likely to be unhappy with the outcome.

Possible Benefits Of Total Knee Replacement Surgery

Regardless of whether a traditional total knee replacement or a minimally-invasive partial knee replacement is performed the goals and possible benefits are the same: relief of pain and restoration of function.

The large majority of total knee replacement patients experience substantial or complete relief of pain once they have recovered from the procedure. The large majority walk without a limp and most dont require a cane, even if they used one before the surgery. It is quite likely that you know someone with a knee replacement who walks so well that you dont know he even had surgery!

Frequently the stiffness from arthritis is also relieved by the surgery. Very often the distance one can walk will improve as well because of diminished pain and stiffness. The enjoyment of reasonable recreational activities such as golf, dancing, traveling, and swimming almost always improves following total knee replacement.

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:

• Severe knee pain or stiffness that limits everyday activities, including walking, climbing stairs, and getting in and out of chairs. It may be hard to walk more than a few blocks without significant pain and it may be necessary to use a cane or walker
• 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 the knee
• Failure to substantially improve with other treatments such as anti-inflammatory medications, cortisone injections, lubricating injections, physical therapy, or other surgeries

Total knee replacement may be recommended for patients with bowed knee deformity, like that shown in this clinical photo.

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Tests Before Knee Replacement Surgery

About six weeks or so before your operation you will have an appointment for a ‘pre-admission’ or ‘pre-assessment’ clinic. At this clinic a nurse will assess your fitness for your knee surgery.

There are several tests that may be needed and they include:

• Blood tests – to check that you aren’t anaemic and that your kidneys and liver are working well enough for you to undergo the operation.
• Urine test – to make sure you haven’t got a urine infection and that there isn’t any glucose in your urine.
• Blood pressure.
• Infection screen – this includes looking for meticillin-resistant Staphylococcus aureus . MRSA is a germ that is difficult to treat and can cause complications of a knee replacement.
• A heart tracing .

You may have the chance to speak with an anaesthetist, physiotherapist, occupational therapist or social worker at this clinic but this isn’t always possible.

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

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.

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Other Causes Of Knee Pain

Sprain or strain to the knee

Injuries to the muscles and ligaments in the knee can lead to pain. Strains and sprains are often due to twisting your knee or a blow to the knee. Falling can lead to knee injuries like this. The symptoms of a sprain or strain include pain, swelling, and difficulty in walking.

Tendonitis

The tendons in your knee can get inflamed and painful. This is typically a result of over-use injuries. Activities like cycling, running, and jumping can be the cause of tendonitis. The symptoms include pain, particularly when you are using the knee in a way that aggravates inflamed tendons.

Cartilage damage

The cartilage in your knee protects the ends of the bones and provides stability to the joint. If you have a knee injury, you might do damage to the cartilage and cause additional pain and swelling in the area.

Undergoing Total Knee Replacement For Knee Arthritis

Experts estimate more than 7% of people in their 70s and 10% of people in their 80s have had a knee replacement.1 The surgery is done to alleviate pain caused by moderate to severe knee arthritis.

More than 90% of knee replacement surgeries are considered successful2 , meaning that after recovery patients have both:

• Less knee pain
• Improved knee function

While common, total knee replacement is a major surgery, and recovery requires several months of physical therapy. For these reasons, patients are asked to commit efforts to non-surgical treatments before considering knee replacement.

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Youre Not Losing Weight If You Need To Which Could Stress Your Knee Joint

The more you weigh, the more stress is placed on the knee joint, which can trigger an increase in pain, according to the American Academy of Orthopaedic Surgeons . Whats more, a study published in August 2017 in the journal Radiology found that when overweight and obese adults lost weight over a two-year period, they significantly slowed down their rate of knee cartilage degeneration.

Does Massage Therapy Prevent Further Knee Damage

It is clear from the research that massage therapy can offer benefits. What is also clear is that massage therapy is paradoxical. It may provide pain relief even as the knee continues to decline its way toward knee replacement.

In our office, we specialize in non-surgical regenerative medicine injections. Here are some links and descriptions to articles on our website to help you with your research in learning more about these options.

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We Can Repair Cartilage By Drilling Holes In Bones But Should We

The traditional explanation of OA-associated articular cartilage damage was mechanical trauma the unavoidable wear and tear of aging and overuse. However, over the last several decades our understanding has shifted we now know that OA is multifactorial in origin. Mechanical trauma does play a role, but so do genetics, nutrition, diabetes, immunity, limb alignment, and even joint shape. Regardless of the underlying mechanism, one aspect remains the same: OA implies articular cartilage damage.

The body is not great at repairing articular cartilage. Prior to the 1950s, there was no established medical technique that provided much help. Patients either endured the pain or underwent risky joint replacement surgery . However, that changed in 1959, when a seven-sentence article appeared in the Proceedings of the Congress of the British Orthopaedic Association. In the surprisingly concise article, Dr. Kenneth H. Pridie, a British clinician who was treating OA patients, noted that If were drilled and the holes were not too far apart, smooth would spread over the surface.

Shortly after publishing this revolutionary procedure, Pridie died, leaving scientists to ponder where he came up with this idea and who would allow him to perform this operation, as well as more practical questions, such as how big of a drill bit? and how far apart is too far apart?

Youre Okay With Avoiding Certain Activities Afterward

Patients should know what to expect after knee replacement surgery and understand that regular high-impact activities may not be advisable.

Total knee replacement is quite successful in enabling patients to return to an active lifestyle patients can perform all types of recreational activities, including hiking, bicycling, skiing, surfing, tennis and golf, Lieberman says. In general, we do not limit activities but suggest that patients avoid impact activities on a consistent basis to reduce wear of the prosthesis.

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What Is Recovery Like

You can start moving the knee the day of your surgery. Your knee function should return rapidly and with less pain than with total knee replacement. Youll work with a physical therapist to mobilize the knee while in the hospital and for two to four weeks after discharge. Youre usually discharged no later than one or two days after surgery.

Youll need medication to guard against formation of a blood clot while in the hospital and maybe for a period of time after youre discharged.

If all goes well, you should be back to full activity in about six to eight weeks. Impact exercises or jogging/running may not be recommended because the replacement includes a bearing surface that can wear. However, activities like tennis, skiing, and other sports are okay. This, of course, is why partial knee replacement is even being considered to return you to activities you enjoy.

Last reviewed by a Cleveland Clinic medical professional on 12/16/2020.

References

Total Knee Replacement Cost

Cost can vary, depending on where you have the procedure and your overall health at that time.

If you have other conditions that are not related to your knees, they may affect the procedure and cost as well.

When considering the cost of the procedure, you should also consider additional costs for:

• your hospital stay

Exercise plays a key role in preventing knee damage, supporting the knee during treatment, and recovery.

Exercise can help prevent joint damage by:

• strengthening the muscles around the knee
• helping you maintain a healthy weight

This is true both before and after surgery, whether for the natural or the artificial knee.

Chronic pain and mobility issues can increase the risk of social isolation. Joining an exercise class may be a good way to connect with other people, some of whom may have similar health issues.

Physical activity can also help you feel good and reduce the risk of anxiety and depression.

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You Have Bad Arthritis

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 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.

Risks Of Knee Replacement Surgery

Knee replacement surgery is a common operation and most people do not have complications. However, as with any operation, there are risks as well as benefits.

Complications are rare but can include:

• stiffness of the knee
• infection of the joint replacement, needing further surgery
• unexpected bleeding into the knee joint
• ligament, artery or nerve damage in the area around the knee joint
• persistent pain in the knee
• a break in the bone around the knee replacement during or after the operation

In some cases, the new knee joint may not be completely stable and further surgery may be needed to correct it.

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Reasons For The Procedure

Knee replacement surgery is a treatment for pain and disability in theknee. The most common condition that results in the need for kneereplacement surgery is osteoarthritis.

Osteoarthritis is characterized by the breakdown of joint cartilage.Damage to the cartilage and bones limits movement and may cause pain.People with severe degenerative joint disease may be unable to donormal activities that involve bending at the knee, such as walking orclimbing stairs, because they are painful. The knee may swell or”give-way” because the joint is not stable.

Other forms of arthritis, such as rheumatoid arthritis and arthritis thatresults from a knee injury, may also lead to degeneration of the kneejoint. In addition, fractures, torn cartilage, and/or torn ligaments maylead to irreversible damage to the knee joint.

If medical treatments are not satisfactory, knee replacement surgery may bean effective treatment. Some medical treatments for degenerative jointdisease may include, but are not limited to, the following:

• Anti-inflammatory medications

• Cortisone injections into the knee joint

• Viscosupplementation injections

• Weight loss

There may be other reasons for your doctor to recommend a knee replacementsurgery.

What About Exercise Following A Knee Replacement

Exercise and sport are recommended after knee replacement, apart from contact sports, which may weaken the cement and lead to loosening of the joint components. Recreational sports including golf, tennis and skiing will gradually become possible depending on how fit and sporty you were before the operation. Cycling is a very good way of building up strength and mobility after knee surgery.

Exercising the main muscle groups around your knee is very important both before and after having a knee replacement. You can download a selection of exercises that are designed to stretch, strengthen and stabilise the structures that support your knee. Try to perform these exercises regularly, for instance for 10 minutes six to eight times a day. However, its important to find a balance between rest and exercise so you dont overwork your knee. Its a good idea to get advice from your doctor or physiotherapist about specific exercises before you begin.

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Talk To Your Doctor About Knee Joint Injections

Knee joint injections should only be explored when more conservative treatments for knee pain have proven ineffective. Before the procedure, your doctor will inject a numbing agent to reduce pain, followed by a corticosteroid to decrease inflammation. They may also discuss options like PRP injections.

While injections may work to decrease pain, knee joint injections do not treat any underlying knee pain causes or halt progressive joint deterioration. Still, when combined with a healthy diet, regular exercise, physical therapy, and other lifestyle changes, they can provide profound relief. Learn more about this option in the following video.

Types Of Arthritis That Affect The Knee

Inflammatory arthritis

This broad category includes a wide variety of diagnoses including rheumatoid arthritis, lupus, gout and many others. It is important that patients with these conditions be followed by a qualified rheumatologist as there are a number of exciting new treatments that may decrease the symptoms and perhaps even slow the progression of knee joint damage.

Patients with inflammatory arthritis of the knee usually have joint damage in all three compartments and therefore are not good candidates for partial knee replacement. However, inflammatory arthritis patients who decide to have total knee replacement have an extremely high likelihood of success. These patients often experience total, or near-total, pain relief following a well-performed joint replacement.

Osteoarthritis

Osteoarthritis is also called OA or degenerative joint disease. OA patients represent the large majority of arthritis sufferers. OA may affect multiple joints or it may be localized to the involved knee. Activity limitations due to pain are the hallmarks of this disease.

OA patients who have symptoms limited to one compartment of the knee sometimes are good candidates for minimally-invasive partial knee replacement .

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Are There Any Reasons Why I Cant Have A Knee Replacement

Unfortunately, some people may not be able to have a knee replacement even though their arthritis is very bad. This may be because:

• your thigh muscles are very weak and may not be able to support your new knee joint
• there are deep or long-lasting open sores in the skin below your knee, increasing your risk of infection.

Similar Conditions That Affect The Knee

Meniscus tear

Sometimes patients with knee pain don’t have arthritis at all. Each knee has two rings of cartilage called “menisci” . The menisci work similarly to shock absorbers in a car.

Menisci may be torn acutely in a fall or as the result of other trauma or they may develop degenerative tears from wear-and-tear over many years. Patients with meniscus tears experience pain along the inside or outside of the knee. Sometimes the pain is worse with deep squatting or twisting. Popping and locking of the knee are also occasional symptoms of meniscus tears.

Since some of these symptoms may be present with arthritis and the treatment of arthritis is different from that of meniscus tears, it is important to make the correct diagnosis. A good orthopedic surgeon can distinguish the two conditions by taking a thorough history, performing a careful physical examination, and by obtaining imaging tests. X-rays and Magnetic Resonance Imaging scans may be helpful in distinguishing these two conditions.

Knee Joint Infections

Also called infectious arthritis or septic arthritis, a joint infection is a severe problem that requires emergent medical attention. If not treated promptly knee infections can cause rapid destruction of the joint. In the worst cases they can become life-threatening.Symptoms of a knee joint infection include:

• severe pain
• fevers and

Again, a joint infection is a serious condition that requires immediate medical attention.

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You Can Participate In Arthritis Research Too

If you are diagnosed with arthritis or another musculoskeletal condition, we encourage you to participate in future studies by joining CreakyJoints patient research registry, ArthritisPower. ArthritisPower is the first-ever patient-led, patient-centered research registry for joint, bone, and inflammatory skin conditions. Learn more and sign up here.