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Knee Replacements: Do I need one?

So you think you need a knee replacement but have been bombarded by information and want to get some truths! Well, below you'll find my non-nonsense overview of knee replacements

Should I get one?

That's a hard question. A knee replacement is a brutal operation, but in the right patient in can be life changing. But on the other hand, in the wrong patient it can be devastating. Basically it's a pain relieving operation, so the first thing you need is pain. I wouldn't consider a knee replacement to be a function improving operation. Chances are your range of motion after the operation will be the same as before the operation, and unless you were grossly unstable, then a knee replacement will not significantly improve function. Having said that, if you cant do certain things due to pain, then yes, it will help with those activities.

The other thing you need is arthritis, best seen on x-ray. If your x-rays don't show advanced arthritis, that is either bone on bone or close to, then the research predicts a knee replacement might not have a high success rate for you. If you have minimal arthritis on x-ray but have knee pain, make sure your surgeon rules out your hip or your back as the cause of pain. Pain doesn't always correlate with the level of arthritis in your knee, however the benefits of a knee replacement do so much more. That is, if you have severe pain but minimal arthritis on x-ray (ie an "A" or a "B" on the images below), then a knee replacement is less likely to be helpful to you than in a patient who may have less pain but more severe arthritis on x-ray. So to get the best results from a knee replacement you want to be at least a "C" but probably a "D" on the images below.

Thirdly, your age is important. A knee replacement will eventually wear out. And the operation you need when it wears out is usually pretty big and hard. And the younger you are when you get your knee replacement, the quicker it will wear out, as you'll generally be more active. Hence you want to be at least 50 if not closer to 70 before you have one.

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