Ask a Doctor: Knee Replacement Options

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I recently saw my family doctor for knee pain that I’ve been having for several months.  X-rays showed that I have arthritis, and I was told I might need a knee replacement.  Being that I’m 53 years old, I’m concerned I’m too young for a knee replacement. What are my options?

There are many things we can try to treat knee arthritis before a knee replacement becomes necessary. Anti-inflammatory medications such as alleve and ibuprofen are good over-the-counter options for arthritis. It is important to stay fit and active for several reasons—keeping your weight down will decrease the amount of stress you put on your knees. It will also strengthen the surrounding muscles and improve range of motion about the knee. I recommend low-impact exercises such as walking, swimming, stationary bikes/cycling, and elliptical machines.

Anti-inflammatory injections into the knee joint are a great option for patients who experience moderate knee pain on a daily basis, and want to avoid surgery. Synvisc injections can offer 6-12 months of relief for up to 75% of patients with mild to moderate knee arthritis. They are a series of injections that are given weekly, for three weeks.  Cortisone injections can be given every three months, and may offer temporary relief from moderate to even severe arthritis.

Determining when to proceed with knee replacement surgery can be a difficult decision to make. When I first see a patient with knee arthritis, I will frequently recommend some type of non-operative treatment if they have not already tried one of the modalities listed above. Knee replacement surgery is a great option for patients who have tried non-operative treatment, and have knee pain that affects their quality of life on a daily basis--whether you want to be able to play a round of golf, enjoy a day of shopping,  play with your grandchildren, or just get a good night’s sleep without knee pain.

Traditionally, surgeons have avoided doing knee replacements on patients younger than 60 years old, due to concerns of material failure, and increased activity level in young patients. With newer muscle sparing surgical techniques, and improved engineering/total knee replacement materials, surgeons are now routinely confident performing total knee replacements in people as young as their late forties. With good surgical technique, and proper care of the knee replacement (low impact exercises, and maintaining a healthy lifestyle), you can expect 30 years from a knee replacement. Surgical options for worn out/failed knee replacements have also improved.

To answer your question, it’s likely that there are many non-surgical options to treat your knee pain at this time. However, if these fail to provide relief, knee replacement surgery can offer a long term solution to your knee pain.

Kirk Dimitris, M.D. is an orthopaedic surgeon at HFM Lakeshore Orthopaedics. To schedule an appointment with Dr. Dimitris, call (920) 320-5241.