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To Replace or Not Replace?

The number of joint replacements performed per year continues to grow and it is anticipated that as the average life span continues, and people continue to remain more active than they have in previous generations that the number will continue to grow. As a matter of fact, there have been articles that have shown some concern as to whether or not there will be enough access to surgeons to actually perform this growing number of replacements!

The question we hear often from patient is “When do I know it’s time to get a knee replacement?” There is no single answer to this question as it varies for each person.

Signs that it might be time for a knee replacement:

  • Your pain persists or recurs over time
  • Your knee aches during and after exercise
  • You’re no longer as mobile as you’d like to be
  • Medication and using a cane aren’t delivering enough relief
  • Your knee stiffens up from sitting in a car or a movie theater
  • You feel pain in rainy weather
  • The pain prevents you from sleeping
  • You feel a decrease in knee motion or the degree to which you’re able to bend your knee
  • Your knees are stiff or swollen
  • You have difficulty walking or climbing stairs
  • You have difficulty getting in and out of chairs and bathtubs
  • You experience morning stiffness that typically lasts less than 30 minutes (as opposed to stiffness lasting longer than 45 minutes, a sign of an inflammatory condition called rheumatoid arthritis)
  • You feel a “grating” of your joint
  • You’ve had a previous injury to the anterior cruciate ligament (ACL) of your knee

If you have a number of these signs or symptoms, it may be time to start having a conversation with your primary care doctor for a referral to an orthopedist that specializes in joint replacements to start to look at alternatives.

Before you make the final decision, there are a number of conservative methods that can be very helpful in reducing pain and may extend the time before getting a knee replacement…or maybe even prevent it all together. There was a recent article in the New York Times that discussed a study that was performed trying to determine whether surgery, or conservative measures were best. In a number of the cases, physical therapy alone was very helpful in reducing pain and helping to avoid surgery, but in a number of other cases, it was the joint replacement that really helped fully restore function and relieve pain.

From the perspective of a physical therapist, even if you are planning to go the route of a joint replacement, having a course of physical therapy prior to the procedure can help to maximize your mobility and strength and really help improve the speed and outcomes of your post-surgical recovery.

Michael Vacon, PT is the Managing Partner of Blue Hills Sports & Spine Rehabilitation of Braintree and Weymouth and can be reached at mvacon@bluehillspt.com