For many patients, undergoing knee replacement surgery is a great option for maintaining, or returning to, an active lifestyle.
The operation can be more extensive and the recovery more extensive than some people realize, though.
Dr. Slade Moore, orthopedic surgeon for Novant Health & Sports Medicine in Kernersville clears up common misconceptions about knee replacement, while offering candid advice for those wondering if surgery is the right path for you.
Get back to enjoying the activities you love.
Myth #1: Surgery is my only option.
Any surgery is a last resort. There are several things that can be done before surgery that can help treat arthritis pain on the knee. There are nonsurgical treatments like losing weight and exercise. And there are anti-inflammatory medicines, and at times, cortisone injections, which can be very helpful in reducing pain and inflammation in the joint.
Myth #2: I shouldn’t exercise on my sore knee.
Yes, the arthritis can get to the point where it prevents people from being able to exercise and then you’ve got to have a different discussion. But in general, with early to moderate arthritis, you can treat with lifestyle changes and low impact aerobic exercise. It helps to keep the muscles strong. It helps to lubricate the joints. It helps you to try to maintain a healthy weight. Exercise, I would say, is the best medicine. It cannot be overstated.
Myth #3: Losing weight won’t make a difference.
A pound of weight loss is about 4 pounds (of pressure) off the knee joint, so a 10-pound weight loss is about 40 pounds of stress off the joint. It can make a huge difference.
Myth #4: I should take pain medicine every day to treat knee pain.
I tell people to take medicine to the point where it’s beneficial to you, but you don’t need to take it every day. Maybe you only need to take it every third day, or every other day to manage symptoms. And if you feel you need to take daily pain medications, talk with your doctor before settling into that habit.
Myth #5: You can get injections to help grow cartilage, the connective tissue in joints.
Beware of places that advertise injections for knee arthritis will help grow cartilage back and take care of your problem. I have people who have come to me and spent thousands of dollars on injections, and they were never going to help.
Myth #6: Having arthritis in my knee means I’m destined for knee replacement surgery.
Not everybody who has arthritis needs to have a replacement. It’s really based on symptoms, what the patient is looking for, how they feel that it impacts their activities, the quality of life, and what some people are willing to put up with. An individual discussion needs to be had with a surgeon.
Myth #7: A knee replacement will make you feel better than ever.
It is a prosthetic. It’s not going to function exactly like a normal (joint) but it’s very good. It’s important to align expectations with what actually can be provided. Having a conversation with the surgeon is really important.
Guaranteeing being pain-free? Those are words that should never be said. I tell people, “I think you’re going to be much happier. Your pain is going to be much less. Your function will be much greater. Can I guarantee you’re going to be pain-free? No, but my hope is that you will be. You’ll know that you had a knee replacement.”
Myth #8: Knee surgery will have you pain-free immediately after surgery.
The first two weeks after a knee replacement are a bear. Typically, they’re pretty difficult. And even at six weeks, there’s still likely to be some pain, swelling and stiffness. I tell patients: This is an active process. A lot of your improvement is early, but you’ll be making improvements for up to a year to 18 months. You’ll get 80% there by six to 12 weeks, but the last 20% is going to be gradual improvement over the next year.
Myth #9: Surgery will be the hard part, then it’s about getting proper rest.
With any orthopedic surgery, you have to invest in the recovery. You have to do physical therapy. It's an active recovery process. If you have your gallbladder out, that's it. You just heal up and you're done. If you have surgery today for a knee, you’re up and walking the day of surgery. We’re having you start therapy right away. When you have a knee replacement, after the surgery is when the work begins.
This is key: If you're not willing to invest in the therapy and the recovery, you ought not have the surgery because you could be worse off.
Myth #10: You should have both knees done at once.
I usually try to talk people out of it, based on the difficulty with recovery. I encourage people to focus on the recovery of one side and get it better, and then decide what to do with the other side.
Myth #11: After knee surgery, patients only have to meet with physical therapist for a few weeks.
A knee requires six to 12 weeks of physical therapy (in person) depending on your progress.
