A knee replacement is a surgical procedure that involves resurfacing a knee joint damaged by conditions like arthritis. Metal and plastic components are used to cap the ends of the bones forming the knee joint, including the kneecap, to restore function and relieve pain. Determining the need for this procedure involves a comprehensive medical assessment.
Recognizing Key Symptoms
Persistent and severe knee pain often signals underlying issues that might warrant considering a knee replacement. This pain interferes with daily activities such as walking, climbing stairs, or getting in and out of chairs. It may worsen with activity and often finds little relief from rest, medication, or other conservative measures.
Another common indicator is stiffness or a significantly reduced range of motion in the knee, making it difficult to fully straighten or bend the leg. Swelling or inflammation in the knee that does not subside with rest or medication can also point to ongoing joint damage. People might also experience knee instability, weakness, or a sensation of the knee “giving way”. Grinding, popping, or clicking sounds accompanied by pain during movement are often reported, along with a visible deformity of the knee, such as bowing inward or outward.
Medical Evaluation and Diagnosis
When knee symptoms become concerning, a medical evaluation is the next step to accurately diagnose the problem. The process begins with a detailed patient history, where the doctor discusses the nature of the symptoms, their duration, severity, and how they impact daily life. This is followed by a physical examination to assess the knee’s range of motion, stability, tenderness, and any signs of swelling.
Imaging tests are fundamental in diagnosing knee conditions. X-rays are commonly used to visualize bone damage, joint space narrowing, and the presence of arthritis, such as bone-on-bone contact, which indicates significant cartilage loss. In specific cases, Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scans may be utilized to evaluate soft tissues or provide more detailed bone structure information, though X-rays are the primary initial assessment tool. Blood tests may also be conducted if inflammatory conditions, like rheumatoid arthritis, are suspected, to help differentiate the cause of knee pain.
Non-Surgical Treatment Options
Before considering surgery, various non-surgical treatments are explored to manage knee pain and improve function. Medications are a common first line of defense, including over-the-counter pain relievers like NSAIDs, or prescription pain medications. Corticosteroid injections can be administered directly into the knee joint to reduce inflammation and provide temporary pain relief. Additionally, viscosupplementation, which involves injecting hyaluronic acid into the joint, aims to improve lubrication and shock absorption.
Physical therapy plays a significant role, offering exercises to strengthen the muscles surrounding the knee, improve flexibility, and reduce pain. Lifestyle modifications are also encouraged, such as weight loss, which can significantly reduce the load on the knee joints and alleviate pain. Modifying activities to avoid high-impact movements and using assistive devices like canes or walkers can also help manage symptoms.
When Surgery Becomes the Right Choice
A knee replacement becomes a consideration when severe pain and disability significantly impair a person’s quality of life and daily activities. This often occurs when conservative, non-surgical treatments have been exhausted and no longer provide adequate relief. X-ray evidence showing significant joint damage, such as severe arthritis or “bone-on-bone” wear, is a strong indicator for surgical intervention.
The decision for surgery also involves the patient’s willingness and understanding of the procedure and the subsequent recovery process. A patient’s overall health status is also assessed to ensure they can safely undergo the surgery and rehabilitation. The decision to proceed with a knee replacement is a collaborative one made between the patient and their orthopedic surgeon, based on a comprehensive evaluation of symptoms, diagnostic findings, and the failure of other treatment options.