When is it right time to go for “Total Knee Replacement”?
I face this question from my patients every day. Hence, I decided to write this article. This has been a major dilemma for most patients and surgeons alike.
I can provide an outline and guide you towards an appropriate answer.
As this is an elective procedure (NOT emergency), the same time constraints do not apply for Total Knee Replacement. First of all, your symptoms should be bad enough for you to consider a Total Knee Replacement. If the pain is not under control with simple pain relief medications and if you are struggling to walk due to pain then you can consider this treatment modality.
Severe arthritis with bones rubbing against each other on the X-ray is NOT an indication for Total Knee Replacement unless there are severe symptoms along with that!
I always advise my patients to explore alternative treatment modalities, before treading the path of Total Knee Replacement. You can try physiotherapy, as there is some evidence to support that strong quadriceps can help in taking some stress off the knee. Knee supports can be tried if helping the symptoms.
Joint injections such as steroids or hyaluronic acid can provide pain relief for 4 to 6 months and can be repeated. Although they do not cure the condition, can help in managing pain.
Glucosamine and Glucosamine + Chondroitin Sulfate tablets orally on a daily basis can help some. Although the evidence for using these is thin, it is worth considering prior to Total Knee Replacement.
After all of this, if you have made a decision to go ahead with Total Knee replacement, then make sure that your medical problems such as diabetes, high blood pressure have been optimised by a physician prior to the surgery.
All the best.