Total knee replacement is performed when severe knee arthritis is no longer controlled with conservative measures—
- Weight loss.
- Periodic cortisone knee injections.
- Proper shoewear.
- Activity modification.
Every person has his/her glass ceiling for proceeding with total knee replacement—
- Inability to perform job responsibilities.
- Intolerable rest pain.
- Severe restriction in walking and climbing stairs activities.
There should be no “urgency” for a total knee replacement, and most patients have had conservative care for several years before knee deterioration is simply not reduced with the above-mentioned measures.
Avoid advice like—
- “Your MRI shows your knee to be much worse than the x-rays; you should act immediately.”
- “You are tearing up your other joints, so come to surgery as soon as possible.”
It is true; we are a linkage system; but secondary damage to the spine, hips, or opposite knee does not occur rapidly. In fact, these body parts are often wearing out simultaneously!