I see a lot of patients of knee pain. A significant percentage of them, especially old age patients come with a severe disability. These patients desperately need knee replacement but they are very reluctant to undergo surgery. This mindset is due to the prevailing myths in the society that knee replacement is one of the most unsuccessful surgeries. Some of the common myths (and real facts)about knee replacements are the following:-
Myth 1: The success rate of the surgery is very low or most of the time patients can’t walk after surgery.
Fact: - In contrary to the common belief, knee replacement is one of the most successful surgery. The success rate is more than 95%. If we talk about patient satisfaction, 80% of the patients are highly satisfied after surgery in terms of pain relief, ease of walking, and range of movement. 15% of patients complain of occasional knee pain and a decreased range of motion. Complications like infection, early implant failure, deep vein thrombosis, etc. are less than 5%.
Myth 2: Knee replacement surgery does not last for more than a few years.
Fact: - Newer knee implants are designed to lasts for more than 20yrs. Life of implant depends upon the physical activity of the patient. If done in patients above 60 yrs with less rigorous physical activity, implant lasts for the whole life.
Myth 3: It is not possible to undergo surgery after the age of 60 years.
Fact:- In fact knee replacement surgery is usually performed in geriatric patients. We do not offer this surgery in the younger population. Age is not a bar for surgery as long as the patient’s general condition allows.
Myth 4: Bending the knee or sitting on the floor is difficult even after the replacement surgery.
Fact: Everyone has a misconception that it is difficult to bend the knee after the replacement, but it is not true. The fact is that it depends mainly on the quality of the surgery, the prosthesis used, and post-operative rehabilitation. Many types of prosthesis allow the same range of movements as a normal joint.
Myth 5: I should continue with medications as long as possible and avoid knee replacement surgery.
Fact - Medicines including painkillers just give symptomatic relief for a temporary duration and prolonged usage can lead to serious side effects such as renal failure, peptic ulceration, etc. That means your knees are not going to be better but your kidney is going to fail. People with advanced arthritis definitely require surgery and cannot be cured by medicines. Several rheumatoid patients require knee replacement at a relatively younger age. Replacement Surgery in the severely damaged knee may reduce the longevity of the replaced joint because of technical complications.
Myth 6: Alternative therapies such as physiotherapy, acupressure, homeopathy, herbs, or braces can cure my advanced arthritis and knee pain.
Fact: There is no alternative to Knee replacement in advanced disease. Trying these modalities may obviously delay the surgery for some time, but cannot avoid it.
Myth 7: Knee replacement is a very painful surgery.
Fact: Surgery is done under regional or general anesthesia and after surgery epidural analgesia is used for a couple of days. Practically you won’t feel any pain.
Myth 8. After a knee replacement, it takes months to recover.
Fact - After 24-48 hours of surgery, we allow the patients to start walking and knee bending. Toilet training is started in 2-3days. The patient need to use a walker for 3-4 weeks. At around 4 weeks patients can participate in outdoor social activities. Ladies can enter the kitchen and start making food as early as 4 weeks from the surgery. The majority of the patients can resume their usual work at 8 weeks.
Myth 9: If the surgery fails or a problem arises with implant post-surgery, there is no chance to repair it again.
Fact: If the surgery fails, revision surgery can be done. Although it is usually not required.
Myth 10: Physiotherapy is necessary after total knee replacement surgery and the recovery is very slow.
Fact: You may not need physiotherapists since the surgery team will teach all exercises during your stay in the hospital and you have to do them after the discharge. Most of the patients can walk without any support after four weeks of surgery. Stair climbing can be started 1 month after surgery.
Myth 11: It is not possible to drive after knee replacement.
Fact: you can drive more comfortably after 8 weeks of surgery.
Myth 12: There is a chance of rejection of knee implant in the body or there may be serious side effects.
Fact: knee implants are made of metals and high-density polyethylene. Implants are compatible with our bodies and can remain in our bodies for years without causing any significant side effects.
Myth 13: Simultaneous both knee replacements are not advisable.
Fact: This is partly true. If the patient is fit and doesn’t have any major co-morbidity like diabetes, hypertension, cardiac problems, bilateral knee replacement can be done in the same sitting. Bilateral surgery in the same setting has many benefits like single hospitalization, single follow-up periods, and less expensive.
Myth 14: Knee surgery is not done in obese patients.
Fact: Knee replacement is routinely done in obese patients. In reality, many patients gain weight in advanced osteoarthritis as walking is very painful and legs are bent. After surgery patient can walk comfortably without pain and this leads to weight loss and also help to control diabetes and blood pressure.