The most common question from patients with significant knee osteoarthritis is, “When should I have a knee replacement?” It is a complex question with no direct answer. Every patient’s situation varies but there are many things that need to be considered when making this decision. Most patients who need knee replacements are those who have “bone on bone” arthritis. There will be significant bone spurs and loss of joint space on their X-ray images. However, this is not the only determining factor. There can be some patients who are bone on bone who have no pain in their knee and are not ready to undergo surgical management.
Conservative treatment should always be the first step in treating knee osteoarthritis. This includes oral anti-inflammatories, physical therapy, and bracing. Other conservative options include corticosteroid injections or visco supplementation injections. If those things are not effective then it is time to start thinking about surgical knee replacement. Other things that may speed along the need for a knee replacement would be significant loss of motion at the knee, persistent pain and limping, mechanical symptoms such as locking, catching, or buckling, and loss of independence from activities of daily living.
A knee replacement is an open surgery to resurface the ends of the weight bearing aspects of the knee joint. The arthritic areas where no cartilage remains are replaced with metallic components. Patients undergoing knee replacement typically will spend one night in the hospital and will be discharged home to undergo outpatient physical therapy. You will be able to walk on the knee with your full weight using a walker. While you will be somewhat independent, it is important to plan on having help at home and you will need someone to drive you to and from physical therapy and follow up appointments. For more information to see if you are a candidate for knee replacement surgery, contact Sports and Orthopaedic Specialists today.
