Is a Knee Arthroplasty Right for You?

Knee pain can get in the way of your life -- whether you simply can't take as many leisurely walks as you used to, or your daily routine is upended by severe symptoms that make it tough to be mobile. A knee replacement surgery, known as an arthroplasty, might be the solution, but it's usually the last resort. A qualified orthopedic surgeon can provide a definitive opinion, but the choices are yours. Here's what you should know.

Get to Know Your Knee Pain

Start by talking with your primary care provider about potential causes of your knee pain. You may be referred to an orthopedic surgeon to discuss a possible knee arthroplasty surgery, and in that case, do some research, write down any questions before meeting with the surgeon, and plan to take notes.

In most cases, knee pain is caused by osteoarthritis. Other sources include rheumatoid arthritis and arthritis resulting from a traumatic injury. Luckily, understanding how arthritis affects the knee can help you develop defenses against this ailment, including strategies to cope with challenges that are brought on by knee pain.

Alternative Solutions to Try Before Surgery

According to the American Academy of Orthopaedic Surgeons (AAOS), physicians should discuss nonsurgical treatment with every patient. But keep in mind that these approaches mostly benefit younger and middle-aged patients wanting to delay surgical intervention. Be prepared to talk about whether any of the following options may or may not work for you:

• Aerobic exercise
• Weight loss
• Orthotics
• Osteopathic manipulative treatment
• Pain medication and anti-inflammatories
• Glucosamine
• Corticosteroid and hyaluronic acid injections

Other Minor Surgical Procedures

For some, surgical options other than a full knee replacement are possible. For instance, your surgeon may suggest a knee arthroscopic procedure, where arthritic areas of the knee are cleaned away using precision instruments. Other surgical options include a unicompartmental (partial) knee replacement and a high tibial osteotomy. However, these are better suited for patients with unicompartmental knee disorders and those who are younger and more active.

Knee Arthroplasty Candidates

Depending on the feasibility and outcome of these alternative solutions, a knee arthroplasty may still be necessary. However, extensive arthritis damage is permanent and a new knee may have limited benefit, so it's important to understand how knee surgery will affect you specifically.

After gathering your medical history, your surgeon will conduct a physical examination, order imaging studies of your knee, and conduct blood tests. He or she will then discuss the results with you and make a recommendation. The AAOS advises you to have knee replacement surgery when:

• Your leg bows from a knee deformity.
• Chronic inflammation and swelling of the knee don't improve with medication and rest.
• Knee pain is severe enough to limit normal activities like walking and climbing steps.
• You experience moderate to severe knee pain when resting.
• You try a number of alternative solutions and pain does not improve.

Knowing the Risks

Knee replacement surgeries are usually successful but every surgical procedure entails risks. Ask your surgeon to explain these in detail. Some complications after surgery include infection, blood clots, and the loosening of the new joint.

You should also look into how knee replacement surgery will impact your life -- in both the short and long term. Good questions for your doctor include:

• How long will I be in the hospital?
• What kind of post-operative care should I expect (home health services, inpatient, and outpatient rehabilitation)?
• When can I return to maximum function and what will my limitations be?
• What kinds of help will I need during recovery (transportation, homemaking, preparing meals, etc.)?
• What are the associated expenses and how much will I have to pay out of pocket?

When it's severe enough, knee pain can rob you of life's joys. Fortunately, you don't have to suffer. Both nonsurgical and surgical options make relief possible. If knee arthroplasty is necessary, be assured that of more than 600,000 annual total knee replacement surgeries, only a fraction fail to make a significant difference.