Total Knee Replacement
Total knee replacements are becoming more common at any age given the wear and tear on the knees. Our William F. Tucker, Jr., MD, has more insight into this procedure:
Total knee replacement is one of the most common and most successful procedures in all of us. On average about 2 knees are replaced for every hip. This is due to the amount of stress which is placed in a localized area in the knee, which is a much more complicated joint than the hip.
Potential causes for arthritis, the reason people have the knee replaced, or increased stress from previous injury, such as sports related injuries, fall, accidents and increased weight. Knees see approximately 6 pounds of stress for every pound of bodyweight so even a small change in body weight has a great impact on the amount of stress seen in the knee.
Sports/activities which place significant stress on the knees and therefore are more associated with the replacements include football, soccer and high-impact activities such as rugby, hockey, and gymnastics.
The conventional wisdom was to wait until you are miserable before having a joint replaced. Following this advice leads to surgery on a severely deformed knee and a severely debilitated patient. My recommendation is to replace the joint when the conservative measures, such as weight loss, activity modifications and use of pain or anti-inflammatory medications like Tylenol, Advil or prescription anti-inflammatories no longer allows what you want to do and need to do to remain healthy.
Newer implants have significant improvements in materials, instrumentation which allows were better more producible correction of deformity, and easier and quicker recoveries which allow this surgery, which was once reserved for a last ditch effort and a miserable, usually out of shape patient, now to be performed in younger, healthier, more active patients.
The time in the hospital is shortened, typically in the range of one or 2 nights in the hospital. The thought process has progressed from the idea of the patient being “sick” to the patient being “well” but having a bad hip or knee. In some cases, the surgery can be performed as a day surgery. My advice to patients is a hospital is a good place to be for short period of time. It is much better to recover at home.
Medical data also indicates that the risk of complications with surgery is significantly higher in patients who are obese. Weight control is one of the most basic and important ways to minimize the need for knee replacement and minimize the risk of problems and improve the lifespan of your own knee as well as a replaced knee.
In summary, when you’re hip or knee is the primary issue keeping you from being healthy and active, don’t keep suffering.