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Does Your Pain Mean It’s Time for a Knee Replacement?

If your knees ache and you’re not always able to do the things you want to do, you may wonder if it’s time for knee replacement surgery. It can be a great choice—for most people, it brings less pain, better mobility and an improved quality of life.

But just because you have knee pain doesn’t mean you need surgery. Brent Albracht, MD, an orthopedic surgeon at Banner Health in Arizona, talked to us about treatment options you can try instead of surgery, and when a knee replacement might be the better choice. 

Here’s what you can try to reduce knee pain

“My goal for patients is pain relief so they can continue to do the activities they enjoy. If I can accomplish this without surgery, that’s preferred,” Dr. Albracht said.

The American Academy of Orthopedic Surgeons recommends trying these non-surgical treatments for knee pain:

  • Over-the-counter Tylenol (acetaminophen).
  • Anti-inflammatories such as Advil (ibuprofen) or Aleve (naproxen sodium).
  • Diclofenac gels such as Voltaren that you can use directly on the knee.
  • Aquatic exercise to maintain activity and lose weight, which can decrease the forces on the knee and improve pain.
  • Physical therapy exercises.
  • Using a cane or brace.

If you’ve tried these options and they aren’t giving you enough pain relief, you may want to consider steroid injections. “Steroid injections in the knee can give you great pain relief for months. They might not be a permanent solution, but they can be a great temporary option until you are ready for a knee replacement,” Dr. Albracht said. And, not everyone is a candidate for rooster comb injections, but they may also be an option for some people.

Here’s when to consider knee replacement

You may want to talk to your doctor about replacing your knee if:

  • You have knee stiffness or pain most days of the week that keeps you from doing the activities you enjoy.
  • You have trouble walking, climbing stairs or getting into or out of bed.
  • Your knee hurts even when you’re resting or sleeping.
  • Your swelling or inflammation doesn’t get better with rest or medication.
  • You’ve tried medications, injections and/or physical therapy, and you’re still having pain.

Don’t assume you’re too old for a knee replacement. If you’re in good health and want to stay active, you might still be a good candidate for a knee replacement, regardless of your age.

Here’s what to know about your knee replacement options

The pain you’re feeling in your knee is likely caused by osteoarthritis, rheumatoid arthritis, post-traumatic arthritis or an injury. These conditions all cause damage to your knee. Depending on which part of your knee is damaged, you may need a partial or total knee replacement.

  • Partial knee replacement might be an option if only one of the knee’s three surfaces (inside, outside or behind the kneecap) is damaged. 
  • Total knee replacement, also called knee arthroplasty, might be the better choice if there is damage to more than one knee surface. 

In either case, surgeons remove the damaged bone and tissue and replace it with a plastic and metal prosthetic joint. “You and your surgeon can decide together which option is best, based on your physical exam and X-rays,” Dr. Albracht said.

What is the recovery process typically like?

Knee replacements have come a long way from the time when people spent multiple days in the hospital recovering from surgery. “Most people leave the hospital the day after surgery, and some do well enough to go home the same day. You and your doctor can discuss how long you’ll likely spend in the hospital,” Dr. Albracht said.

Newer pain control options decrease pain and limit the need for opioids. And most people can bear weight and walk on their knee replacement within the first day of surgery. In most cases, your doctor will want you to start knee movement, weight-bearing and physical therapy the day of or day after your surgery. “Early motion and strengthening help you avoid problems such as stiffness and blood clots,” said Dr. Albracht.

And moving your knee is crucial for a good outcome, so a physical therapist will work with you on regaining your range of motion after knee replacement. You’ll also work on your motion on your own in the first few months.

You’ll need some help around the house from a friend or family member at first, but you should be able to do everyday tasks on your own within three to six weeks. You should be able to return to work in four to six weeks if you have a desk job and in about three months if you have a job that requires more standing and movement. Talk to your doctor about your plans for returning to work if your job includes manual labor.

“While full recovery takes several months, our hope is that you have full motion and are happy with your results between six to 12 weeks,” Dr. Albracht said. And today’s knee replacement models can last for 15 to 25 years or more. 

The bottom line

If knee joint pain is preventing you from doing the daily activities you enjoy and medication, physical therapy and injections haven’t helped, you might want to consider a knee replacement. Our free Joint Pain Test can help you evaluate your knee pain. And if you’d like to talk through your pain management options with an orthopedic expert, reach out to Banner Health. 

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