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Knee replacement surgery, arthroplasty of the knee

The risk of delaying Knee Replacement Surgery

Knee replacement surgery or arthroplasty of the knee is performed when there is severe pain that doesn’t respond to medicine, mobility issues or considerable damage to the knee.

Some common reasons why your doctor may recommend knee arthroplasty:

  • Osteoarthritis: This occurs when cartilage (protective tissue that surrounds the bone) breaks down, causing pain and limiting joint function. Over time, this joint disease worsens, making it unable to climb, walk or run with ease. Sometimes, along with the cartilage, the adjoining bone may also be affected. Osteoarthritis usually happens to people who are middle-aged or older.
  • Rheumatoid Arthritis: Unlike osteoarthritis, this happens due to the immune system attacking tissues. This causes pain and inflammation along with stiffness of joints, tenderness and even fatigue. The disorder can occur at any age, with symptoms that might come and go.
  • Post-Traumatic Arthritis: This is a type of osteoarthritis that develops due to an injury. While the symptoms do not last for long, it could extend beyond six months, making it chronic.

There may be additional reasons why your Orthopedic doctor might suggest knee replacement surgery depending on your lifestyle, symptoms, and condition.

What is Knee Replacement Surgery, and how does it work?

Before getting ready for knee replacement surgery, it’s best to understand how the procedure works. Knee replacement surgery consists of resurfacing the knee with metallic and plastic polymer parts or prosthetic implants that help support the joint. This enables mobility and reduces pain in the damaged area.

There are two types of knee replacement surgery:

  • Total Knee Replacement: This procedure entails building an artificial knee and replacing both sides of the joint. Around 90% of modern total knee replacements are known to function well for up to 15 years.
  • Partial Knee Replacement: Only the affected portion of the joint is replaced. Damaged tissue and bone are removed via a small incision, leaving for a shorter knee replacement recovery time.

Risks of delaying Knee Replacement Surgery

From the fear of pain to the doctor’s recommendation, there could be multiple reasons for delaying surgery. Hence it is necessary to make an informed decision when doing so. Most doctors initially go with alternatives to knee replacement. If non-surgical methods fail, surgery is recommended.

Following are some of the dangers of delaying knee replacement surgery:

  • Damaged Bones and Joints: The longer you wait, the more wear and tear of tissues around the knee occurs. Due to this, the bones at the joint grind against each other instead of moving smoothly. This leads to further damage that reaches the bone, along with increased pain.
  • Surrounding Muscle and Tissue Weakens: Limited mobility, constant inflammation, and increased pressure could prevent proper movements, in turn weakening the muscle. The more pain you feel, the less you’ll move. This leads to the degradation of muscles, making your leg more vulnerable.
  • Constant Pain Management: Not treating your knee calls for more pain medication and relief. Severe pain affects the quality of life, preventing fitness and mobility. This, in particular, affects your overall health as well.
  • Bad Posture: Over time, with the pain and discomfort, your posture may also be affected. Bad posture gives way to pain in other body parts. For example, you might develop a limp that further affects your back or ankle when moving.
  • Risk of Injury: Due to improper movement and restricted mobility, you could risk damaging the other knee as well. This is because of the constant pressure from using your ‘good’ knee/side. Additionally, you risk losing stability when moving, making you prone to falling.
  • Surgical Complications: The longer you wait, the extent of damage sustained increases. Hence, making the surgery more complex and longer to perform.
  • Increased Recovery Time: The older you get, the more time it takes for your body to heal and adjust, thereby increasing your knee replacement recovery time frame.

Also, read: Knee pain – when to see a doctor?

Does delaying total Knee Replacement Surgery have any damaging effects on your hips?

While the hip and knees work in close coordination and support body weight, in the short term, delaying total knee arthroplasty is unlikely to have damaging effects. However, over the years, there could be some pain in the hip due to odd postures and movements. This may happen as the knee balances off-centre loads and may not do so efficiently.

If surgery is delayed

Knee joint replacement surgery may be delayed due to underlying conditions or individual circumstances. Here are some tips to help manage the pain:

  • Whichever gives you more relief, warm or cold compresses help. Keep them for around 10 to 15 minutes, about three times a day.
  • Light movements that help stretch and enable movements. It is best to seek a physical therapist to suit individual needs.
  • Using a knee brace, cane or walker.
  • Hyaluronate injection keeps the joint lubricated and helps as a shock absorber as well.

What are the advantages of Knee Replacement Surgery?

Depending on individual cases, along with avoiding the above risks, patients may have the following benefits:

  • Reduction or elimination of pain
  • Ability to resume normal activities
  • Better or improved mobility
  • Reduced risk of injury

Tips to maintain healthy knees

Taking care of your knees may help prevent or delay the onset of problems.

  • Daily exercise prevents stiffness and promotes mobility of joints.
  • Increase uptake of anti-inflammatory food or adopt supplements like fish oil.
  • Stretching helps muscles relax as well as warms them up for a workout. It is also known to reduce injuries and release endorphins.
  • Don’t push yourself too hard when exercising. Alternate between low-intensity and high-intensity workouts and always gradually include weights.
  • Avoid sitting with your knees bent deeply for long periods.

In closing

The benefits of arthroplasty of the knee are evident as they provide relief from pain and return mobility. Opting for knee surgery too soon without considering alternatives might lead to minimal benefits and revisions. However, one must note symptoms and approach a doctor before the condition worsens. 

While the doctors decide options based on your age, scans, joint function, and intensity of pain, the choice of having knee surgery lies with the patient. So, depending on the discomfort and how much your knee affects day to day life, knee replacement surgery could prove to be of great benefit.

Also, read: Quality of life after Total Knee Replacement Surgery

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Author: Dr Debashish Chanda
An experienced Orthopedic surgeon, Dr. Debashish Chanda specialised in robotic knee and hip surgeries from Germany. He brings with him over 14 years of experience in treating a wide range of orthopedic ailments with a focus on knee surgery.
 
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