National Bone And Joint Day: When Should You Consider Knee Replacement Surgery?

Knee replacement surgery is a significant medical procedure typically recommended for individuals who suffer from severe knee pain and disability that cannot be alleviated through other treatments. Understanding when to consider this surgery and what it entails is crucial for making an informed decision. Leading orthopedic experts Dr Atul Mishra and Dr Debashish Chanda provide insights into the key indicators and considerations for knee replacement surgery.

Key Indications for Knee Replacement Surgery

“Knee replacement surgery is considered a major procedure typically recommended when other treatments have failed to relieve severe knee pain and disability,” explains Dr Atul Mishra, Senior Director, Orthopaedics & Joint Replacement, Fortis Hospital, Noida. He outlines several critical indications for considering this surgery:

1. Severe and Persistent PainChronic and severe knee pain that persists despite conservative treatments such as medications, physical therapy, or lifestyle changes may necessitate knee replacement surgery. This type of pain often disrupts daily activities, including walking, climbing stairs, and even sitting or lying down.
2. Chronic Inflammation and SwellingLong-term knee inflammation and swelling that do not improve with rest, medications, or other treatments can indicate severe joint damage, making surgery a viable option.
3. Reduced Mobility and StiffnessSignificant stiffness and a limited range of motion in the knee, making it difficult to perform everyday tasks, may indicate the need for knee replacement surgery.
4. DeformityVisible deformity of the knee, such as bowing in or out, can be a sign of severe joint damage that may be best addressed with surgery.
5. Failed Conservative TreatmentsWhen non-surgical treatments such as physical therapy, medications, weight loss, and assistive devices like braces or canes fail to provide sufficient relief, knee replacement surgery becomes a consideration.
6. Impact on Quality of LifeIf knee pain significantly affects your quality of life, including your ability to work, sleep, or engage in social and recreational activities, surgery may be the best option.
7. Advanced OsteoarthritisIn cases of advanced osteoarthritis or other degenerative joint diseases where the cartilage in the knee is severely damaged or worn away, knee replacement surgery can help restore function and alleviate pain.
8. Previous InjuriesPrevious knee injuries that have led to chronic pain and dysfunction, and that have not responded to other treatments, may also necessitate knee replacement surgery.

Evaluating the Need for Surgery

Dr Debashish Chanda, Lead Consultant, Department of Orthopedics, CK Birla Hospital, Gurugram, emphasizes that knee replacement surgery should not be solely based on imaging results such as x-rays or MRIs. “The main indication for knee replacement surgery is when the patient is unable to walk or perform their day-to-day activities,” he says. This means difficulty in walking, carrying out daily routines, going to the bathroom, or engaging in any work activities.

Dr. Chanda further explains that another critical criterion is the frequent use of pain medications. “If the patient is taking pain medicines, such as painkillers, on a daily or weekly basis to manage pain and continue with their activities, it can cause damage to their kidneys, liver, and heart. Therefore, relying on painkillers while continuing to walk is problematic.”

He also notes that knee arthritis might not always be present, but if a patient is suffering and unable to manage otherwise, surgery should be considered. “There is no other absolute indication for surgery,” he adds. For patients who can still walk several kilometers and perform daily activities with only minor pain, alternatives such as exercise, medication, and physiotherapy can be very helpful.

Relative Indications for Surgery

Other relative indications for knee replacement surgery include spinal or knee deformities or significant discrepancies in the size of the legs due to deformity. These conditions might warrant surgery, but they are not absolute indications.

Consulting with an orthopedic surgeon is crucial to evaluate your specific condition and discuss the potential benefits and risks of knee replacement surgery. As Dr Atul Mishra highlights, the decision should be based on a comprehensive assessment of pain, physical function, overall health, and the extent of joint damage.

Dr. Debashish Chanda’s insights further emphasize the importance of considering functional limitations and the impact on daily life rather than relying solely on imaging results. By understanding these key factors and consulting with medical professionals, individuals can make informed decisions about knee replacement surgery and its potential to improve their quality of life.