By Wanda Marie Thibodeaux
Total knee replacement can provide dramatic relief from pain and inflexibility. Not everyone qualifies for the procedure, though. These are some of the primary areas physicians consider when trying to figure out if a patient is a good candidate.
You probably don’t need total knee replacement surgery if you’re getting some relief from other options, such as medication injections, physical therapy, over-the-counter medication, or shedding a few pounds to reduce pressure on the joint. However, if these choices are losing their effectiveness, you might be a good surgery candidate.
Knee specialists usually recommend total knee replacements if you’re age 55 to 70, although age alone doesn’t dictate whether the surgery will benefit you. Younger patients tend to have higher failure rates and are more likely to outlive the implants, meaning the odds of needing a revision surgery are higher.
Level of Pain, Swelling, and Stiffness
Pain, swelling and stiffness (lack of flexibility) can occur even with mild or intermediate knee problems. Doctors usually recommend surgery only when these factors unquestionably are affecting your quality of life. You might want to discuss arthroplasty if daily activities are troublesome, you’re skipping out on things you love to do and you have negative feelings about the way your knee is forcing you to be or act.
In a severely injured or diseased knee joint, the cartilage often wears unevenly. This phenomenon creates a bowed or knock-kneed appearance in the leg. You might be a good surgery candidate if you have this issue, especially if the knee “gives out” or you can feel the joint grinding or having difficulty gliding smoothly. The alignment of the knees can affect the pelvis and spine, so bowed or knocked knees can translate to hip or back pain, as well.
Good knee doctors will conduct a series of imaging tests in addition to a physical exam to determine just how bad the damage to your knee is. He or she also uses these tests to look at tissues around the knee to figure out if they can support the new joint well enough. Your doctor will recommend surgery only if the images indicate that the procedure will address any underlying problems you might have.
Surgeons do not limit knee surgery candidacy by weight alone, but as WebMD points out, each pound you gain puts 3 more pounds of pressure on the knee joint. For this reason, if you’re overweight or obese, your doctor might ask that you slim down a bit first to decrease the stress you’d put on the reconstructed joint. Weight loss also usually improves general health areas such as blood pressure and immune system function, which can increase the odds you come through the surgery without complications and that your recovery is fast.
Ideal total knee replacement candidates are healthy, normal-weight individuals age 55 to 70 who aren’t having success with alternative options, whose level of swelling, pain and stiffness is lowering quality of life and who show signs through tests or the appearance of the leg that the joint has uneven wear. Your doctor can assess you to help you make a final call about whether you qualify.