Osteoarthritis or “wear and tear” arthritis of the knee affects about 20% of Americans older than 45 and is the most prevalent joint disease in the U.S. as well as the most common source of chronic pain and disability.1 Arthritis is simply inflammation of the joint.
In the case of osteoarthritis, the inflammation occurs when the soft cartilage that lines the ends of the bones is worn away. The result is painful “bone on bone” contact and often the formation of bone spurs. Though no one knows exactly what triggers osteoarthritis, injury, advancing age and increased body weight play a role.
There is no “cure” for osteoarthritis, but there are many nonsurgical and surgical options that may help improve quality of life by allowing more activity with less pain.
In the early stages of knee osteoarthritis, simply losing some weight or activity modification (i.e., less high-impact activity) may be all that is needed. For more persistent pain, Tylenol, NSAIDs (ibuprofen, naproxen) and physical therapy may help. However, as the pain becomes more consistent and the arthritis more advanced, it is a good idea to establish care with an orthopedic surgeon. Bracing, cortisone injections and certain prescription medications can all be powerful tools to help reduce pain and restore function without surgery. Be wary of unproven, expensive options which are often not covered by insurance. Be sure to consult with a reputable orthopedic surgeon and avoid treatments that sound too good to be true.
For many patients who have failed nonsurgical management, surgery may be recommended. Common options include arthroscopic procedures and partial or total knee replacement. It is very important to make this decision with your orthopedic specialist as no single procedure is right for everyone.
For those patients ready for a knee replacement, it is important to know what to expect. These procedures are often performed in as little as 30 minutes and in many cases, patients can go home the same day. Patients are allowed to bear their full weight right away. Knee replacement is the only procedure that will address arthritis and other knee problems (such as meniscus and ligament tears) with a single surgery.
With appropriate physical therapy, patients can expect to be walking normally and driving within four weeks and back to work and/or more strenuous activity within 8-12 weeks. However, full recovery may take 8-12 months and some patients achieve their goals faster than others. Preoperative knee motion and activity level directly influence the time to recovery, with more active patients typically recovering faster.
Many advances have helped improve patient experience with knee replacement. Better techniques, implants and anesthesia all play a role. However, there is still misleading information which is why it is so important to consult with a reputable surgeon. Most experts agree surgeon volume is one of the most important predictors of a successful outcome. As with nonsurgical options, be wary of surgeons who offer “new” procedures that sound too good to be true. Many of these procedures and techniques are unproven and in the wrong hands can lead to inferior outcomes.
In summary, knee osteoarthritis affects a large portion of the American population. Fortunately, there are many effective treatments — both nonsurgical and surgical. All share the goal of restoring function and limiting pain. If the decision is made to proceed with knee replacement, using an experienced, trusted surgeon is critical. Many orthopedic specialists perform knee replacement, but few dedicate their practice to it. Never hesitate to get a second opinion — good surgeons will be unoffended.
In the right patient, knee replacement is a powerful tool. However, no two patients are the same and the procedure is not right for everyone. Talk to your orthopedic provider if you have knee pain and want to learn more.
Learn more about joint services at Northside.
Reference:
- Wallace, Ian J., Steven Worthington, David T. Felson, Robert D. Jurmain, Kimberly T. Wren, Heli Maijanen, Robert J. Woods, and Daniel E. Lieberman. "Knee Osteoarthritis Has Doubled in Prevalence Since the Mid-20th Century." Proceedings of the National Academy of Sciences of the United States of America 114, no. 35 (August 29, 2017): 9332–9336. https://doi.org/10.1073/pnas.1703856114.
