Oh, those achy knees! The older we get, the more likely we are to have knee pain. In some cases, cortisone shots or physical therapy can be used to treat the pain. In the most severe cases, either partial or total knee replacement surgery may be warranted.
“The knee, like everything else in our bodies, is subject to aging,” says Kim Nonas, a Chicago-area physical therapist for VNA Healthtrends. “There’s a layer of cartilage that protects the bones in our knees. Once it wears away, you’re down to bone on bone.”
As we get older, the cartilage is more likely to wear away and cause osteoarthritis. In those older than 65, osteoarthritis affects one in three people. Exacerbating the problem of balky knees is excessive weight, which is more likely in the less active, less mobile older population. As knee pain becomes more pronounced, mobility can become even more restricted and lead to additional weight gain, putting even greater stress on the knees. Those who maintain a healthy weight through diet and exercise are less likely to have osteoarthritis or other knee problems in their older age – though genetics, bone deformities, joint injuries, repetitive stress and other factors also play a role.
While knee pain can often be treated with a cortisone shot or physical therapy, there are cases when the pain becomes so severe that partial or total knee replacement surgery is the best course of action. “The deciding factor is when the pain gets to the point that it’s intolerable and is impacting your ability to perform your regular routine tasks,” Nonas says. “Surgeons are usually very good about assessing your options.”
If the individual requires surgery on both knees, Nonas reports that it’s usually best to do the surgeries individually. “If one of the knees is significantly worse, you do that one first,” she says. “The surgeries are frequently done relatively close together — perhaps three, six or nine months apart.”
Recovery from Knee Replacement Surgery
The recovery time for those who have had knee replacement surgery is usually pretty quick. According to Nonas, the physical therapist will typically have the patient up and walking with an assistive device in the first few days after surgery. “By the second week, they’re typically able to use a cane. Usually by the third or fourth week, many of our patients are walking without the aid of an assistive device,” she says. “Strengthening of the knee prior to surgery provides a better, faster recovery.”
Once the patient gets through the knee replacement surgery, physical therapy and exercise is required to rebuild the joint muscles. Among the most effective exercises are knee extensions, partial squads, knee bends and step-ups to strengthen the quads.
The life expectancy of a new knee is usually 10 to 15 years, Nonas reports. Younger patients — i.e., those in the 50 to 65-year-old age bracket, many of whom are very physically active and therefore have experienced a lot of wear and tear on the knee – may need another knee replacement surgery sometime later in life.
Knee Replacement Surgery Risks
Some may hesitate at the thought of surgery, worrying about the risk and concerned about whether it will truly be effective. While no surgery is entirely risk-free, in most instances, the advantages of partial or full knee replacement surgery greatly outweigh the risks. Knee replacement surgery today is minimally invasive and has a lower risk of rejection. Knee implants are typically made of titanium or a cobalt-chromium based alloy that is strong, durable and lightweight.
“When you get to the point of having the surgery, that’s usually the best option,” says Nonas, adding that most people are glad they went forward with having their knee(s) replaced. “I can count on one hand the number of people I’ve encountered who later regret having the surgery.”