Myths and facts related to total knee replacement

In our routine orthopaedic OPD’s almost 30-40% of the patients have arthritic and badly damaged knees. These patients run from one doctor to another for some permanent treatment. Taking painkillers for years altogether pose threat to the vital organs especially the kidneys, cardiovascular system, stomach etc. Total knee replacement is the best treatment modality for these patients. But, there are lot of misconceptions among the masses related to the surgery, here I am mentioning the most common myths and facts related to the knee replacement surgery.

Myth 1:  In knee replacement surgeries the whole joint is replaced like a kidney transplant.

Fact: In knee replacement surgeries, only the damaged surface (articular cartilage) of the joint is replaced preserving the bone and the associated major ligaments. Technically it’s more of a resurfacing surgery rather than a replacement.

Myth 2: The success rate of the Knee Replacement surgery is low.

Fact: With the latest implant designs and techniques the success rate of replacement surgery has increased to 85-90%.The patient lives a pain free and comfortable life after the surgery with a dramatic improvement in the activities of daily living.

Myth 3: The knee replacement surgery can’t be performed in old age patients.

Fact: Knee replacement surgery is usually performed for old age patients mainly due to age related degeneration (wear and tear) of the joint. Their age group is usually from 60-80 years. But, younger patients also undergo replacement surgeries due to various other pathologies like rheumatoid arthritis, post traumatic arthritis, infection, tumor etc.

Myth 4: The knee replacement surgery doesn’t last for more than 10 years.

Fact: Knee replacement surgery is a lifetime surgery for the elderly as the new joint lasts over a period of 18-25 years, depending on the activity level of the patient. If the surgery is done in a younger age group, the patients might need a revision surgery in their lifetime.

Myth 5: The knee replacement surgery can’t be performed in patients having Obesity and Diabetes mellitus.

Fact: The patients having arthritic knees with underlying comorbidities like diabetes or obesity benefit the most from the knee replacement surgeries. After the surgery the patient can walk and jog around pain free which helps them to lower the body weight and regulate blood glucose levels. Latest treatment guidelines for diabetes guarantee a safe peri-operative period.

Myth 6: The knee replacement is a very painful surgery and need a long term physiotherapy.

Fact: Modern day pain management protocol makes the surgery relatively pain free. Patient just needs a supervised physiotherapy for 2-3 days in hospital. Exercises are simple and can be performed by patients independently at home.

Myth 7: The patient can’t bend the knee after the total knee replacement surgery

Fact: The patients can perform all routine daily activities after the surgery. The patients can bend the knee fully but are advised to avoid squatting and sitting cross-legged.

Myth 8: If the surgery fails, there is no chance of improvement.

Fact: The surgery usually doesn’t fail but there is a risk of infection or implant loosening. In that case the patients will require a revision surgery.

Dr Shah Nisar is an Orthopedic Trauma and Joint Replacement Surgeon posted at GMC, Baramulla.