Avoiding a knee replacement
A knee replacement surgery swaps out the damaged ends of bones in the leg with synthetic prosthetic parts so that the patient can regain mobility in the knee. However, some patients may not want to undergo knee replacement surgery, or may not be suitable for it. In this article, consultant orthopaedic surgeon Mr Amit Shah details the alternative to knee replacements, and what patients can do to look after their knee health.
Knee replacements are typically used to treat joints that have majorly deteriorated due to arthritis, fractures and injury. It is a major surgical procedure, which is why many surgeons will recommend it as a final option for patients who are suffering from significant pain and immobility from their dysfunctional knee. Knee replacements can last up to only 25 or so years, so most of the patients who undergo a knee replacement tend to be older, around the ages of 60-80, in order to avoid undergoing revisional surgery once the replacement fails.
What are the alternatives to knee replacement surgery?
Alternative treatment options that patients can explore before necessitating knee replacements can include:
- Lifestyle adjustments, such as losing weight to reduce the strain on their knees.
- Medications to manage pain.
- Steroid injections to the knees to manage swelling and pain.
- Using walking aides and tools such as walking sticks and special podiatry insoles to better the gait and distribute weight.
- Osteotomy, which is a minor and minimally invasive procedure where the end of the tibia (shin bone) is reshaped to better distribute weight and reduce pressure on the damaged end.
How can the knees be protected?
For those who want to avoid needing treatment for their knees in the future, there are some preventative measures they can implement to protect the condition of their knees.
Physical activity
Staying adequately active has multiple benefits for the knees. It helps with weight loss, which reduces the strain and pressure on the knees; it strengthens the muscles around the knee, adding more support to the structure; and it increases the flexibility of the knees and legs so that the muscles are looser, balanced is improved, and future injuries can be avoided. Exercises should ideally be low-impact for the knees, such as swimming and cycling – avoid overdoing activities such as running, jumping, and football. Patients should keep in mind to stretch properly before physical activity, wear protective gear, and take care to not overwork during exercise. Patients can also opt to undergo a physical therapy programme, where specialised sessions of exercises and stretches are formulated to better the condition of certain bodily structures, such as the knee.
Eat well
A balanced diet can improve joint health and lubrication. Foods high in omega-3 fatty acids in particular are recommended, such as fatty fish and flaxseeds, as they have anti-inflammatory properties. Weight management can also be assisted with a balanced diet.
Best foot forward
Using supportive footwear with arch support and cushioning will have long-term benefits. Well-designed shoes will absorb shock and distribute weight across both legs. Avoid wearing shoes with heels, weak straps, and rocking soles. Specialised accessories such as insoles and braces (known as orthotics) to support the knees and feet can be acquired from an orthopaedic specialist or podiatrist.