When Ravinder Singh, a 73 year-old man came for his orthopaedic check-up, his difficulty with walking was quite evident. He had been suffering from knee pain and slowly his mobility had begun to recede. “5 years ago, my doctor had told me that I would need a knee replacement surgery soon” Mr. Singh told us. “But I thought I was too old to have my knees replaced, so I tried to manage without the surgery.”
Mr. Singh came to see Dr. Biren Nadkarni, an orthopaedic surgeon at Sitaram Bhartia, when he couldn’t step outside his house anymore because of his knee pain. “I have a very active social life” he said “so along with the pain, I was also starting to feel lonely and depressed because I had to be at home all day.”
Misconceptions about aging, along with many other misunderstandings that people harbour about knee replacement surgery, prevent them from regaining a better quality of life. According to Dr. Nadkarni, there’s a lot of fear attached with the term “knee replacement” which is unwarranted.
“Knee replacement is a misnomer because we are not replacing anything” he explains. “We’re just putting caps on the knees – one on the thigh bone, one on the shin bone, and plastic in between to take care of the joint. It’s still your own knee with your own muscle.”
“I’m too old to have a knee replacement surgery”
Mr. Singh’s primary concern was that he was too old for a knee replacement surgery. “I thought I couldn’t have this surgery after I was 60 years old” he said. On the flip side, patients who need a knee replacement may also feel they’re too young to have a surgery done.
According to Dr. Nadkarni, age was a consideration when the replacements would last only for around 10- 15 years. But changes in lifestyle have led to changes in technology. “We see people developing arthritis much earlier” he says. “If you’ve tried physiotherapy or medication and you’re still not feeling better, we won’t ask you to wait until the proverbial age of 60 to get your knee replaced.”
In fact, knee replacement parts which are available now have increased longevity since some of them last for as long as 30 years. “Younger patients can get this surgery done without a problem” explains Dr. Nadkarni.
“I don’t need surgery immediately”
Another misconception regarding knee replacement is that people can wait as long as possible before getting the surgery done. Doctors advise against an extended or lengthy waiting period because your muscles may get weak. “Even if you get the surgery done at a later stage, your body is not able to recover fast enough.” says Dr. Nadkarni. “You’ll need more time in physiotherapy.”
The right time to get your knee replacement surgery is when you’ve had crippling knee pain for a long time and if medications or physiotherapy haven’t helped. “If you need a daily painkiller, or you’re waking up with stiffness in your knees that keeps you from carrying out your daily activities, you should see a doctor about knee replacement surgery.”
“I’m too obese/need to lose weight before I can have surgery”
Since being overweight does put pressure on the joint and wears them down earlier, patients often feel that they should lose weight before getting surgery done. “That rarely happens in actuality” says Dr. Nadkarni.
“In fact, overweight or obese people who have their knee surgery done are able to lose weight faster afterwards because their mobility is restored. Unless and until someone is morbidly obese and at a BMI of 35 or more where bariatric surgery may be indicated, patients should not put off the surgery.”
But what about people who need both knees replaced? Do they have more complicated situations? Do they need to have one replacement done at a time?
According to Dr. Nadkarni, you should get only one knee replaced if just one knee is a problem. Since most patients tend to wait after they’ve been advised for a knee replacement surgery, the other knee also gets affected and then both need to be replaced. “A bilateral (both) knee replacement is a bigger surgery, but most people are able to take it” he says.
Mr. Singh had a successful knee replacement and he was able to walk without assistance after a few weeks of physiotherapy. “I wish I hadn’t waited so long” he mused. “If I had known I could be independent again so quickly, I would have had the surgery sooner.