The question for many is ” how do I know if I need a total knee replacement?“ That can be an answer that may differ from person to person, however, it becomes quite obvious once you find your overall quality of life suffering because of the chronic pain daily that you have to endure.
Once you are finding that you are experiencing chronic knee pain that is not being relieved by over the counter medications, the first step is to see your local orthopedic surgeon for a consult which will initially consist if an x-ray generally with you lying and standing, though the positioning may be somewhat different depending on the surgeon but most agree on a picture with you weight-bearing on the affected leg is a must to determine the actual joint space left.
Your surgeon by looking at the x-rays can get a good idea how much cartilage you have to spare if any in the knee and can then make some recommendations on what course of action to take.
For instance look at the above photo, the knee on the right is a knee that is considered bone on bone in the medial compartment. How much pain that individual is going through is up for debate, however, it is probably enough to get him or her into the surgeon’s office for this x-ray.
And you can see the deformity with the lower leg as well, classic total knee replacement candidate.
That looks like a painful knee to me.
If you have some cartilage to work with in your knee, for instance, many surgeons may recommend a series of injections to help build up your joint space in your knee with a gel type substance.
In some cases, this may buy you some time to help prolong surgery and in some cases, it may not. I have witnessed both ends of the scale with previous patients and clients. Some have felt much better, some it did not help at all.
I went through this same process many years ago with one knee and at the time I was strictly bone on bone, in other words, there was nothing left for me to do but get my knee replaced due to the extreme amount of pain I was in along with the obvious knee deformity I had due to the lack of supporting cartilage in my knee.
Generally, the driving factor in the overall decision will between you and your surgeon and the amount of pain you are currently having to endure and how it is affecting your overall quality of life.
That only you will know. I have for instance a left knee that is bone on bone right now, the pain tends to come and go however it is getting to the point where it has started to affect my quality of life, therefore, I will not tolerate dragging my leg around another year.
A total knee replacement wil be in order.
Everyone is different when it comes to pain and how they function, just because a knee is bone on bone, for instance, does not necessarily mean that you are ready for surgery. It will depend on the pain level.
Myself and of course your surgeon has seen knees that look like they have been through a grinder along with being bone on bone, however, the patient is really not complaining of severe pain at this time so they hold off on the surgery.
Others have had a total knee replacement and if you look at their knee in an x-ray it does not appear all that bad, you will see some changes in structure but it has come to a point with the patient that the pain day in and day out has become too much.
So the bottom line here is you are really only the one to know when it is time for a total knee replacement. And of course, if you want to consider having this operation or need more information always get another medical opinion.
If two orthopedic surgeons recommend you have the surgery due to your complaints then there is no need to hold off to the point you have to come into the hospital or outpatient center in a wheelchair, just get it done!
If you have any questions or comments either leave a comment below or you can email me at firstname.lastname@example.org and I will be glad to give you a reply to your questions.
Make a decision by getting informed and talking with your orthopedic surgeon and a physical therapist in how to prepare yourself physically and mentally once the decision is made.
Richard Haynes PTA, CPT
Total Joint Fitness LLC