If you have painful knee arthritis, there are a number of non-surgical treatment options available. Over time, you may find that these are no longer working as well. Many patients find that knee injections, for instance, tend to work for a shorter duration with each subsequent injection. You may be left wondering when you should take the step towards a knee replacement. This is a highly personal decision, but here are some things to consider:
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You’ve been told by an orthopedic surgeon that you have significant arthritis
There are other reasons that a knee can hurt besides arthritis. Knee replacement is indicated for significant arthritis. Arthritis means loss of cartilage, the bearing surface of your knee. This can typically be assessed on an x-ray. Patients without significant arthritis don’t reliably experience improvement in pain from a knee replacement, unfortunately.
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Your knee is affecting your quality of life on a daily basis
You may find that you are avoiding stairs. That one mile walk you used to take every day has become intolerable. Nighttime pain is a red flag, as sleep issues have a profound effect on quality of life. When your knee is to this point despite having tried conservative therapies (see below), it may be time to consider having the knee replaced.
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The simpler fixes are no longer working
There are a number of nonsurgical options to treat knee arthritis. A recent study in The New England Journal of Medicine found that physical therapy was superior to knee injections for decreasing pain and improving function for patients with mild to moderate arthritis. This doesn’t mean that injections aren’t a good option; rather, I interpret this as saying we shouldn’t ignore physical therapy for arthritis! Low impact exercise and over-the-counter medications such as acetaminophen (Tylenol) and ibuprofen can also be beneficial.
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The surgery will be reasonably safe
There are a number of factors that affect the safety of getting through a knee replacement safely with a good outcome. Thankfully, most patients do! These factors include diabetic control, blood circulation issues, the ability to heal a surgical wound, smoking status, among many others. We want to keep our patients safe, and fortunately, some of these factors can be improved to make the surgery safer.
The decision whether to undergo a knee replacement is highly personal. If you find yourself facing this decision, hopefully this has been useful! Additionally, it never hurts to reach out to your surgeon. We want to help you whether that involves surgery or not, and sometimes a thorough discussion can clarify things.
About Dr. Mark Jordan
Dr. Mark Jordan provides orthopedic services at Door Orthopedic Center in Sturgeon Bay. The Door Orthopedic Center at Door County Medical Center is a state-of-the-art facility paired with a top-notch orthopedic team that can get you back to daily living and your favorite activities as soon as possible. To schedule an appointment at Door County Medical Center's Door Orthopedic Center, visit our Door Orthopedic Center page or call Door County Medical Center at 920-743-5566.