The decision to have total knee replacement surgery is usually made cooperatively by you, your family, your family physician, and your orthopaedic surgeon. Your physician may first refer you to an orthopaedic surgeon for a thorough evaluation to determine if you might benefit from this surgery. There are several reasons why your doctor may recommend knee replacement surgery. You might be recommended to undergo a knee replacement if you have:
1) Severe knee pain or stiffness that limits everyday activities, including walking, climbing stairs, and getting in and out of chairs. You may find it hard to walk more than a few blocks without significant pain and you may need to use a cane or walker. 2) Moderate or severe knee pain while resting, either during the day or at night. 3) Chronic knee inflammation and swelling that does not improve with rest or medications. 4) Knee deformity — a bowing in or out of your knee. 5) Failure to substantially improve your condition with other treatments such as antiinflammatory medications, cortisone injections, lubricating injections, physical therapy, or other surgeries. There are no absolute age or weight restrictions for total knee replacement surgery. Recommendations for surgery are based on a patient's pain and disability, not age. Most patients who undergo knee replacement are aged 50 to 80, but orthopaedic surgeons evaluate patients individually.
Total knee replacements have been performed successfully at all ages in patients with degenerative arthritis. An evaluation with an orthopaedic surgeon consists of several components: A medical history: Your orthopaedic surgeon will gather information about your general health and ask you about the extent of your knee pain and your ability to function. A physical examination: This will assess knee motion, stability, strength, and overall leg alignment. X-rays: These images help to determine the extent of damage and deformity in your knee. Other tests: Sometimes, blood tests, or advanced imaging such as a magnetic resonance imaging (MRI) scan, may be needed to accurately determine the condition of the bone and soft tissues of your knee. Your orthopaedic surgeon will review the results of your evaluation with you and discuss whether total knee replacement is absolutely required to relieve your pain and improve your function. Other treatment options — including medications, injections, physical therapy, or other types of surgery — will also be considered and discussed.
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