An early diagnosis is helpful when you need to decide
If knee pain is bothering you right now, get an early diagnosis which is the biggest advantage for knee preservation. A focused consultation with a knee specialist and early imaging can be the difference between preserving and replacing the knee.
When is knee replacement the right answer?
Knee replacement is a life-changing surgery when joint damage is too advanced for preservation to give reliable, long-term relief. When your quality of life is compromised, it is time to get your knee replaced. At the same time, this major surgery can only be done when the body is fit. If your knee is troubling you and your body can withstand anesthesia, it is time to get your knee replaced. In advanced cases of knee wear and tear, a knee-preserving procedure will not meaningfully improve function. Replacement is suggested when:
- X-rays and MRI show severe, widespread cartilage loss, large osteophytes and deformity
- Pain is constant and interferes with sleep, walking, standing or basic self-care inspite of physiotherapy, medicines and lifestyle changes
- The knee bends or straightens so little that walking is difficult or unsafe
- The joint feels unreliable even during simple activities raising the risk of falls
- Work, household chores and social or family commitments have had to be cut back
- All other options are exhausted
Even though replacement is a good surgery it is not a perfect one. In a study of 1,703 knee replacement patients in Ontario, Canada, 81% were satisfied with the result and 19% were not. That is one reason specialists look to save the natural knee initially while diagnosing and choose replacement only when options have been exhausted.
What can you do before the knee reaches the stage of knee replacement?
If you have knee pain, do not get by with pain killers but see a knee specialist promptly, if you notice these symptoms.
- Pain that lasts more than 2 to 3 weeks
- Swelling, locking or "catching" inside the knee
- A feeling of giving way or instability
- Difficulty with routine activities
- Visible deformity, or progressive bow-leg or knock-knee
A consultation will show whether simple measures, physiotherapy or knee preservation treatments are adequate, or whether more advanced procedures are required. For younger and middle-aged patients, our specialists consider arthroscopic cartilage procedures like ACI, meniscus repair and HTO rather than knee replacement.
What should I do about my knee pain today?
- Observe your pain. How long has it been there? Where exactly does it hurt? What triggers it?
- Protect the knee. Stop the movements that trigger pain. If the pain is acute, follow RICE: Rest, Ice, gentle Compression, Elevation.
- Check for red flags. Red flags could be swelling, a feeling that the knee might give way, or persistent pain.
- Plan a proper assessment at an orthopaedic centre that specialises in knee preservation and replacement.
- Ask the right questions. Is my knee at a stage where preservation is possible? What are the non-surgical and joint-preserving options before replacement?
The goal is to see if knee preservation is available
At Ortho-One, knee preservation is treated as the first option. As a pioneering centre in arthroscopy, joint preservation and sports medicine, our approach combines precise diagnosis, minimally invasive techniques and rehabilitation to protect the natural joint for as long as possible.
Dr. David V Rajan, Knee and Shoulder Arthroscopy Surgeon at Ortho-One says that every knee is assessed on three pillars:
- Stage of damage. Is the problem a cartilage defect, a meniscus tear or early arthritis, or is the whole joint worn out?
- The patient's goals. Is this a young athlete, a working adult or a senior? Can the patient squat or sit on the floor?
- The long-term plan. Which treatment gives the best function over the next 10 to 15 years, and which would only give relief for a couple of months?
The team chooses knee-preserving options confidently as they have a high-volume experience in arthroscopy and daily knee surgery that’s performed by sub-specialised surgeons while still recommending replacement when the joint is clearly beyond preservation.
Key takeaways
- Knee replacement is suggested as an option when the damage is too advanced for preservation to give lasting relief.
- Early diagnosis is the biggest advantage for saving the knee.
- See a specialist when you’ve had pain for 2 to 3 weeks, swelling, locking or giving way.
- Every knee is assessed based on the stage of damage, the patient's goals and the long-term plan.
Frequently asked questions
When is knee replacement necessary?
Knee replacement is necessary when joint damage is too advanced for preservation to give reliable, long-term relief. These include severe and widespread cartilage loss, constant pain despite physiotherapy, medicines and lifestyle changes, and when all other options are exhausted.
When should I see a knee specialist?
If you have pain that lasts more than 2 to 3 weeks, swelling, locking or catching inside the knee, a feeling of giving way, difficulty with routine activities, or a visible or worsening bow-leg or knock-knee.
What can I do for knee pain at home?
Stop the movements that trigger the pain. If the pain is acute, use RICE for 3 to 5 days: Rest, Ice, gentle Compression and Elevation. Do not rely on strong painkillers without medical advice.
How does Ortho-One decide between preservation and replacement?
Every knee is assessed on three pillars: the stage of damage, the patient's goals, and the long-term plan that gives the best function over the next 10 to 15 years.
Before you choose knee replacement
If you have any of the signs above, book an appointment with a knee specialist at Ortho-One, Coimbatore.
Sources
- Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KD. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clinical Orthopaedics and Related Research. 2010;468(1):57-63. https://pubmed.ncbi.nlm.nih.gov/19844772/
