Knee replacement surgery

One of the most common questions that a physician hear in his day to day practise is, Doctor, I had knee pain for last 6 to 7 years. So, is knee replacement surgery the last option for relieving the pain?

Knee pain essentially means that the patient feels pain in the knee joint. It does not mean that the patient is has complete arthritis or he require knee replacement surgery. Hence, it is important to understand that a patient can have both acute knee pain and arthritis.
However, when a patient’s X ray shows manifestation of arthritis, he/she are generally advised surgery. But, if the source of pain is not arthritis, then patient do not need knee replacement surgery.

There are three categories of arthritis patients who do not need Knee replace surgery. The first and foremost category is patient who present signs of acute sprain of median collateral ligament. We all know arthritis is caused by wear and tear in the cartilage of the knee joint. In some cases, the ligaments that support the joints rupture due to walking on etc.

As a result, a sprain occurs in the knee joints. The treatment for patients with ruptured ligament and sprained joints include complete rest, and ice application. The second category of arthritic patient is called over use. Thes patients over use or strain their joints, which implies that they move the knee joints for more than 90 degree of angle.

In this condition, pain can be managed by taking rest, taking pain medications, avoiding squatting, avoiding sitting in cross legged position, etc. The third and the last category include arthritis patient who present with synovitis. Synovium is a thick jell like protective layer that surround the knee joints.

Patient with synovitis have damaged, irritated, and inflamed synovium. In this case, the knee pain can be relieved by injecting cortisol in the joint. Other methods include proper rest, ice application, avoid squatting, etc.

Hence, it can be said that Knee replacement surgery is not the gold standard for treating arthritis in all sunset of people, but the surgery is advisable, if
•    Patient has severe knee pain
•    No history of over use, MCL sprain, synovitis
•    Night pain
•    Continuous pain throughout the day with/without use
•    Knee deformities

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