The knee joint is the largest and one of the strongest joints in the human body. It joins the thigh with the lower leg and performs a major role in all daily activities such as walking, running, standing, sitting, and getting up.

Needless to say, the health of the knee is important to stay active and mobile. But some conditions such as knee arthritis or trauma to knee joint can damage it to an extent that it becomes hard to do even the simplest of activities that involve the knee. There can be the extreme pain in and around the knee joint that restricts its movement.

Though there are many non-surgical alternatives such as medications, physiotherapy, and the use of walking supports (sticks and braces) that may give some relief to the patient if all these fail to work and pain becomes unbearable, you must consider undergoing knee replacement surgery.

Knee replacement involves the removal of worn out ends of the bones along with any hard cartilage that is causing pain and deformity of the joint. The removed parts are replaced by prosthesis or implants made from metal or plastic. They enable the joint to move and bend freely.

Recent advances in technology have made knee replacement surgery a very safe and effective procedure that not only gives relief to the patient from pain but can also correct leg deformity.

However, there are many instances, when the knee replacement is not actually required but is still conducted. This scenario usually leads to the premature failure of the knee implants and thus, warrant the need for a revision surgery. This article talks about some of the indications for knee replacement surgery and when should it be actually carried out.

When is knee replacement surgery recommended?

An orthopaedic surgeon may recommend knee replacement surgery for several reasons, including the following:

• Damaged knee due to arthritis or other rare destructive diseases of the joint.
• Severe knee pain or stiffness that limits your daily activities. A knee that pains during walking, sitting or getting up really makes life very difficult and dependent upon others.
• Moderate or severe pain in the knee even during rest.
• Chronic knee swelling that has not responded to any kind of treatment.
• Knee deformity that can be due to trauma or disorder such as the bow or knocked knees.

All these knee problems may require knee replacement surgery if all other methods of treatment such as medications, injections (cortisone or lubricating), physiotherapy etc. have failed to give relief to the patient.

But it is not always that a total knee replacement is required. Depending upon the deformity of the knee joint, total, partial, or kneecap replacement is done.

Is there any age or weight limit for the surgery? 

Age is not a criterion for knee replacement surgery but being overweight (greater than 200 pounds) can affect the outcome of the surgery. Excessive body weight increases the risk of dislocation of the replaced knee and also makes recovery difficult. That is why the patient is advised to keep weight under control before and after surgery.

It must be noted that knee replacement surgery is equally successful at all ages. It gives relief to the young teenager with juvenile arthritis and is also recommended to the elderly patient with degenerative arthritis.

Do you actually need the knee replacement?

Apart from knowing the eligibility criteria for knee replacement, another most important factor to consider before making a decision for the surgery is to understand what the procedure can and cannot do. You must understand the pros and cons of the procedure and then move ahead.

Though most of the people who undergo knee replacement feel a drastic improvement in their knee pain and significant improvement in knee mobility but replaced knee cannot possibly be your original knee that was before deformity. You would be able to perform activities such as walking, driving, swimming, light biking and hiking, golf, and some other low-impact sports. So you must have realistic expectations from the replacement surgery without any false hopes. It will improve pain and mobility but won’t be like knee before deformity.

Secondly, the implants placed during knee replacement can also begin to wear with its usage. Moreover, if it used excessively, the wearing process may speed up and can cause a loosening of the joint. This may again cause pain in the joint and raise a need for revision surgery.

The process of evaluation for the surgery is quite tedious and may take weeks before the actual procedure is performed. You may need to undergo various tests to find out your fitness for the procedure. Even after undergoing the procedure, the first few weeks are difficult and you may need the full-time support of your family members to perform essential activities.

Knee replacement surgery also requires good financial support. The cost of evaluation, surgery, and post-operative care can be taxing for some. So you must review the knee replacement surgery cost guide to make financial decisions before the surgery.

Any surgery can have complications and so can knee replacement surgery. Although the rate of complications after knee replacement surgery is quite low (less than 2 per cent) but there can be an infection, formation of blood clots, implant problems, nerve injury, or continued pain in the knee.

So you must consider all the pros and cons and also discuss your concerns with your orthopaedic surgeon before making a decision to undergo knee replacement surgery.