By Dr. Michael Henry, ND
Knee replacement surgery (also known as knee arthroplasty) is a major medical procedure that can significantly improve the quality of life for individuals with severe knee joint issues, specifically severe cases of osteoarthritis where the cartilage that lines the inside of the joint has deteriorated and a loss of joint space is visible on imaging.
However, it is not a decision to be taken lightly, and there are instances when delaying knee replacement surgery may be your best decision. In this article, we'll explore why and when postponing knee replacement surgery may be in your best interest.
When Considering Alternatives to Surgery
1. Conservative Treatment: Before rushing into surgery, it is recommended to explore conservative treatments for knee pain and dysfunction.
Some of these options include physical therapy, injection therapies (such as hyaluronic acid and prolotherapy), medications, lifestyle changes, and the use of assistive devices like braces or canes.
Many people experience partial or complete relief from their knee pain through these methods which allows them to delay or even avoid surgery altogether.
2. Age and Activity Level: Consideration of age and activity level is crucial. Younger individuals, especially those under the age of 50, may want to delay knee replacement surgery if possible.
The artificial joint typically has a lifespan of around 15-20 years, so delaying surgery can help ensure that the joint replacement lasts for as long as possible. Active individuals may also choose to delay surgery to maintain their mobility and continue participating in high-impact activities.
Consult with your surgeon and the rest of your healthcare team to see what limitations you may have on your preferred activities if you were to undergo knee arthroplasty.
3. Risks and Complications: Knee replacement surgery, like any surgery, carries risks and potential complications. Delaying surgery might be advisable if the risks outweigh the benefits, especially if there are underlying health conditions that could increase surgical risks.
4. Lifestyle Modifications: Some individuals can manage their knee pain and improve function by making lifestyle modifications.
Weight loss, exercise, and dietary changes can reduce stress on the knee joint and alleviate pain. This is intuitive when you think about it - if we lose excess body fat, and strengthen the muscles and other tissues surrounding the knee joint, we can reduce the strain that we apply through the joint on a daily basis.
For those with mild to moderate knee issues, these changes may delay the need for surgery.
5. Personal Preferences: Ultimately, the decision to have knee replacement surgery is a personal one. It's essential to take into account your goals, pain tolerance, and overall quality of life.
Some people may choose to delay surgery because they aren't ready to commit to the recovery process, while others may prioritize immediate pain relief.
When to Proceed with Knee Replacement Surgery
While delaying knee replacement surgery can be a viable option in some cases, it's essential to know when it's time to proceed with surgery:
When conservative treatments have been exhausted and are no longer effective in managing pain and improving function.
When knee pain significantly impairs daily activities and quality of life. When you can’t get out of bed in the morning, and you can’t put any weight on your leg, despite trying other treatments, the risk of staying immobile long-term outweighs the risk of surgery.
When joint damage is severe and irreversible (as seen on imaging), as delaying surgery may result in further joint deterioration.
Ultimately, the decision to delay knee replacement surgery should be made with careful consideration, taking into account factors such as age, activity level, lifestyle modifications, and personal preferences. Talking with your healthcare professional is essential to assess your specific situation and determine the most appropriate course of action for managing knee joint issues.
But remember, it's your life, and you are responsible for advocating for your health. When you see your practitioner, come prepared with questions about your options, and if you feel unsatisfied with the answers you’re provided, get a second opinion.