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Under the Knife: Ways to avoid Knee Replacement Surgery

knee replacement, surgery, OA,

When the arthritis pain gets bad – a knee replacement seems like the logical next step right?
WRONG!

When arthritis in the knee gets to be severe and limiting in your day-to-day life, you will likely be referred to an orthopedic surgeon. It is there you start talking about your options. But that is often just the beginning of your journey. Even if you decide to have surgery, the wait list for a joint replacement can be quite the wait – I have seen it be over a year!

The decision to get a joint replacement is not one that should be taken lightly. An honest conversation with your doctor is going to be important to see if this decision is right for you. Many surgeons now try to hold off on performing surgery for as long as possible. This is because the implant doesn’t last forever (last timelines I heard were 15-20 years before you would need to get a revision done but the implant improves all the time). Often when this happens, people are then into their 80s or above and having another invasive surgery has more risks.

But joint replacements are common!
Total knee replacement, or TKR, is a surgery where they replace your knee with a metal implant. TKRs are common. It is estimated 10% of 80 years olds have a knee replacement in the US. That’s 1 in 10!

Over the last couple of years with this surgery becoming more common, serious harmful events have become relatively rare. But like any surgery, its success is not guaranteed and having the replacement doesn’t guarantee you will be pain free.

Some of the risks of TKR are
• Blood clots
• Infections
• Persisting pain after surgery
• Loss of range of motion and muscle mass

For some this is the next step, for others they want to avoid it if they can.

So what happens if you learn about your options and say NO. That you decide you want to avoid surgery if at all possible. Well here’s two things you can try to avoid going under the knife.

1. Lose a couple pounds if you need to.

The extra few pounds you carry puts extra stress on your knees. By losing that weight you can alleviate some of that pressure. Your weight is actually one of the biggest risk factors for needing a joint replacement. Persons who are overweight are 40-100% more likely to need surgery!
2. Strengthen your muscles!

The stronger your legs are the better. We have written before at how more arthritis on your X-Ray doesn’t necessarily mean you’ll be in more pain. Building the strength in your legs helps to support your knees and puts less stress on them. If nothing else, the stronger you are before surgery, the stronger you’ll be after surgery!

If you want to avoid surgery, you need to put in the work. The pain isn’t going to go away on it’s own. Exercise is an important part of both the leg strengthening as well as the weight loss. I know for some, when they exercise the pain in the knees can get worse. That doesn’t have to be the case! Physiotherapy can help give you the proper program that won’t make the knee pain worse. Give it a try. Only good things will come of it!

References:
DeFroda, S. F., Rubin, L. E., & Jenkins, D. R. (2016). Modifiable risk factors in total joint arthroplasty: A pilot study. Rhode Island Medical Journal (2013), 99(5), 28-31.

Jonsson, H., Olafsdottir, S., Sigurdardottir, S., Aspelund, T., Eiriksdottir, G., Sigurdsson, S., . . . Gudnason, V. (2016). Incidence and prevalence of total joint replacements due to osteoarthritis in the elderly: Risk factors and factors associated with late life prevalence in the AGES-reykjavik study. BMC Musculoskeletal Disorders, 17, 14-016-0864-7. doi:10.1186/s12891-016-0864-7 [doi]

Leyland, K. M., Judge, A., Javaid, M. K., Diez-Perez, A., Carr, A., Cooper, C., . . . Prieto-Alhambra, D. (2016). Obesity and the relative risk of knee replacement surgery in patients with knee osteoarthritis: A prospective cohort study. Arthritis & Rheumatology (Hoboken, N.J.), 68(4), 817-825. doi:10.1002/art.39486 [doi]

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