On bended knee: knee replacement is the surgery of the millennium

Knee replacement surgery is one of the most common surgeries for middle-aged people. However, having it young means the need for a revision surgery later in life. Patients need to weigh the benefits and risks of the surgery and future revisions against the help the surgery gives them in the present.

You've lived a pretty hard life. You work 9 to 5, and you are on your feet a lot. Maybe you played a sport in high school, and you had an injury that you never got over. Even worse, you may have put on some pounds and the strain on your knees has totally ruined them. You have severe arthritis, and the joints in your knee just can't do their job anymore. You need a knee replacement.

Worn-Out Knees? Knee replacement is no problem!

Knee replacement surgery is also known as knee arthroplasty. It is indicated when the cartilage and bone in your knee has been worn down to the point where it is causing you pain and limiting the range of motion that you have. Your doctor surgically cuts away bone and cartilage to replace it with metal and plastic polymers. Replacement knees are now specifically designed for your age, weight, and other measurements. Your doctor can customize your replacement knee specifically for you.

You may need knee replacement surgery if

• you have severe arthritis,
• your knee pain is debilitating,
• you are unable to get around,
• other treatments have not been able to help you,
• you are over 55 years old, or
• you are otherwise in bad health

Replacing a knee can actually help you regain your mobility and assist you in getting more exercise to regain your health. Doctors now perform minimally invasive knee replacement surgery that only requires a 3 to 5 inch incision instead of the traditional 12 inch incision.

Replacement knees are all the rage

Part of the problem with replacement knees is that everybody is getting them and getting them at a much younger age. According to the Agency for Healthcare Research and Quality, for women ages 45 to 64, 16 out of 10,000 people were hospitalized for knee replacement in 1997 while in 2009 42 out of 10,000 people were hospitalized for the surgery. For men, in 1997, 11 out of 10,000 people had knee replacement surgery, but in 2009 that number jumped to 28 out of 10,000 for people ages 45 to 64. As you can see, younger people are needing this surgery more often. Some experts point to obesity as a cause. However, since knees last for 20 years, younger patients may agree to the surgery since the revision timeline is so far away. For the 65 to 84-year-old group, the number of patients also increased. The rate of knee replacement surgery increased by 69% for women and 55% for men between the years 1997 and 2009.

The trouble with replacement knees

Knee replacement, though a fairly routine and safe surgery, is not without its risks. Before agreeing to any surgery it is important to weigh the risks and long-term consequences of a prosthetic device. Knee replacement is a major procedure and with any surgery there is the risk of infection, blood clots, heart attack, stroke and nerve damage. A main problem with knee replacement is the risk for infection around the joint. This can occur at any point after your surgery, not just the immediate post-operative period. After the infection is controlled, another knee replacement surgery may be necessary. Knees do wear out. Most of the newer replacement knees last about 20 years, but it is not unheard of to need a replacement sooner than that. Consult with your doctor to know exactly how long your replacement knee will last. Then take into account how old you will be and how difficult it will be at that age to undergo knee replacement. Weigh that information against your current situation and decide the best course of action for you and your health.

References:

• Mayo Clinic; Knee Replacement
• Everyday Health; Big Jump in Knee Replacement Surgery; November 2011

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