Should You Have Knee Replacement Surgery?

From the WebMD Archives

If you're in a lot of pain when you walk or get up from a chair, and you can't keep up with your daily activities, you might wonder: Should I think about knee replacement surgery?

More than 700,000 in the U.S. get it done every year. And most of them get big-time pain relief and can go back to their everyday life. Does that mean surgery is for everyone with knee problems?

"Knee replacement surgery is not like getting a tire change at a NASCAR pit stop," says orthopedic surgeon David Lewallen, MD, at the Mayo Clinic College of Medicine in Rochester. "It's a major procedure and isn’t something that has to be done unless your symptoms can't be controlled with simpler measures."

How to Make a Decision

If you are considering a new knee, think it through carefully.

Pain, swelling, and stiffness. It might be time for surgery if it hurts so much when you walk or go up and down stairs that it's hard to get through your day. Another sign is that your knee is painful at night or even when you're resting.

Other treatments didn't work. "We always try to start with simpler things first and move to more complicated solutions," Lewallen says. That means before you get surgery, you've probably already tried anti-inflammatory drugs or cortisone shots for pain and swelling, physical therapy, and maybe even weight loss.

Knee deformity. "Do you notice you're becoming bowlegged or knock-kneed or your knee won't go straight anymore?" says orthopedic surgeon Claudette Lajam, MD, of the NYU Langone Medical Center in New York City. "It's usually a giveaway when that starts to happen."

Quality of life. If your pain limits what you can do every day, you may want to talk to a surgeon. "It's about timing," says Charles Nelson, MD, chief of joint replacement at Penn Orthopaedics in Philadelphia. "People think surgery when symptoms are bad enough that they're not functioning to their satisfaction."

When Knee Surgery May Not Be for You

Infections. Make sure you get them treated before surgery. For instance, take care of gum infections. It will lower the chance of getting an infection in your new knee.

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Other medical problems. Do you have heart or lung problems, diabetes, or blood clots? It may raise the chances of complications from your surgery. You'll need to get these under control before you can make a decision about knee replacement.

Other reasons for your joint trouble. "Is your knee really causing your pain?" Lajam says. "Sometimes you get pain from the low back that causes your knee pain. Sometimes people with bad hip arthritis have pain in the knee." Work with your doctor to make sure you've found the real reason you hurt. If you don't, your knee may still bother you just as much months after surgery.

Get Ready

Are you getting a new knee? Here are a few things to know:

Line up some help. You won't be able to drive or get around for several weeks, so you'll need someone to do your errands and everyday chores. Make sure you've got a support system in place. "I ask people: Do you have pets?" Lajam says. "Do you have stairs? Who does your shopping? Think about these things now so you're not worrying about your cat when you're trying to recover."

Plan to make changes. Keep up with your physical therapy so your joint and muscles get strong and heal. Even after you recover from surgery, you may have to make a few lifestyle changes. If your weight wasn't healthy before, it's a good idea to get fit. A healthy diet and exercise should be key now.

WebMD Feature Reviewed by David Zelman, MD on January 26, 2016

Sources

SOURCES:

American Academy of Orthopaedic Surgeons: "Total Knee Replacement."

CDC: "Inpatient Surgery."

Claudette Lajam, MD, orthopedic surgeon, NYU Langone Medical Center; assistant professor of orthopedics, Hospital for Joint Diseases-New York University School of Medicine.

David Lewallen, MD, orthopedic surgeon, Mayo Clinic; professor of orthopedics, Mayo Clinic College of Medicine.

Charles Nelson, MD, chief of joint replacement, Penn Orthopaedics; associate professor of orthopedic surgery, Hospital of the University of Pennsylvania.

UCSF Medical Center: "Preparing for Knee Replacement Surgery."

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