25 Oct Knee Replacement in Older Adults
Knee replacement, also called arthroplasty, is one of the most common and successful surgical procedures available and has improved the daily lives of millions of people. The primary reason to have the surgery is for severe osteoarthritis of the knee which causes pain, swelling, and keeps you from doing the activities your enjoy.
According to research presented in 2014 to the American Academy of Orthopedic Surgeons, about 4.7 million Americans are living with an artificial knee. The report indicates the overall rate of total knee replacement (TKR) increased by 120% from 2000-2009. For patients from the ages of 45 to 64, TKR increased 188% and for patients from the ages of 65 to 84 that number was 89%. Medicare is the primary payer of knee replacement surgery.
Older adults may think they won’t benefit from knee replacement surgery. However, in a 2008 JAMA Internal Medicine study, patients 75 and older received positive outcomes from having joint replacement surgery. Researchers followed 174 elderly patients (average age 75) with severe knee or hip osteoarthritis for 12 months. During that time, 29 percent had joint replacement surgery. While the majority of patients in the study took several weeks to recover, they experienced less pain and disability long-term. On average, those who had surgery were walking in less than two weeks and doing housework after seven. Their scores on a standard scale measuring pain and function had improved 50 percent after a year. Furthermore, patients over 75 had similar benefits and recovery as those in the 65-to-74 age range.
Deciding When to Have Knee Replacement Surgery
Knee replacement is considered an elective surgery. And while the vast majority of surgeries are problem free, the procedure can bring some potential risks and possible complications. Rehabilitation begins almost immediately after surgery with full recovery taking from 3 to 12 months. To avoid surgery, your doctor may initially suggest you lose weight which can help to reduce knee pain. Each pound you are overweight is the equivalent of about 5 extra pounds on the knee. In addition, exercises to strengthen muscles and increase flexibility, and taking over-the-counter pain reducing medications can reduce arthritis pain and inflammation. Procedures including injections of steroids, hyaluronic acid, platelet-rich plasma (PRP), and bone marrow concentration may also help you avoid surgery.
Consider the following if you are deciding on knee replacement surgery:
- Severe knee pain that limits your everyday activities;
- Moderate or severe knee pain while resting, day or night;
- Long-lasting knee inflammation and swelling that doesn’t get better with rest or medications;
- X-rays showing bone touching bone somewhere in the knee;
- A bowing in or out of your leg;
- Knee stiffness;
- No pain relief from over the counter medications.
There are a number of different surgical methods for knee replacement including: TKR, partial knee replacement, kneecap replacement or a complex or revision knee replacement. Your orthopedic surgeon will help you determine what option is best for you.