5 Reasons you should get Total Knee Replacement surgery done at the appropriate time

Knee Replacement surgery - why you can’t always wait for the PERFECT time.

I belong to a society, where people tend to delay their Total Knee Replacement, for an indefinite time, out of fear and innumerable myths surrounding this surgery, even after they have been prescribed Total Knee Replacement by a Joint replacement Surgeon. Many of them continue taking Pain Killers, as they are easily available in my country Few of them will reach a stage where they are practically unable to walk or come in wheelchairs.

A few of them will even stop drinking water at night as they cannot independently go to the washroom anymore, and at night everybody else is sleeping. Nobody to accompany them to Washroom !!!! Highly undesirable.

Total Knee replacement is largely a successful surgery as a lot of developments have taken in this field over the last two decades. In the majority, it will last more than two decades. Why shall You not unnecessarily delay Total Knee replacement?

If you delay your Total Knee Replacement unnecessarily, the following may happen:

1. Progression of deformity, Increased or Severe deformity: Over a period of time, waiting for knee replacement, you tend to develop deformities in the knees. Few patients wait so long that they develop severe bow legs (See Picture Below). While performing Total Knee Replacement Surgery your knee is made straight by soft tissue dissection. It is obvious that more is the deformity at the time of surgery, more is soft tissue dissection required to straighten your knee (correct the deformity). So, by unnecessarily waiting and developing severe deformity in the knee you have added one more step of “additional soft tissue releases to correct the deformity”. More is the soft tissue dissection more a patient may feel pain in the postoperative period (after the surgery).

Moreover, though the majority of surgeons are experienced enough to handle any type of deformity, you make your Total Knee Replacement Surgery a technically challenging operation. I use PINLESS Computer Navigation Technology to correct these severe deformities.

2. Development of Spontaneous Fracture in the Bone (without Injury): Many patients with deformed legs with severely degenerated Knees, develop a spontaneous fracture in leg bone (Tibia), unduly waiting for surgery. This happens because of abnormal loading (eccentric loading) of deformed bone. See the picture below.

3. Loss of range of movement : The majority of patients by unnecessarily waiting for Total Knee Replacement, develop loss of range of movement at the knee. With the passage of time, you gradually tend to lose movement at the degenerated knees because of pain and reduced mobility. At the time of surgery of Total Knee Replacement, a stiff knee requires more soft tissue dissection, to implant an artificial Knee.

Note, that when a surgeon has to put an artificial knee (implants) inside the knee, the surgeon needs full bending of the knee on the operation table. So, here also by unnecessarily waiting for Total Knee Replacement Surgery, if you have developed loss of range of movement, you will require more soft tissue dissection and again you have made technically challenging operation for a surgeon.

Moreover, in the post-operative period, you need to do extensive physiotherapy for a longer time (as compared to the knee with a full range of movement) to regain your range of movement back.

4. Loss of function: As you are waiting for knee replacement, with a painful knee, you lose activities of daily living, over the period. Many of you who are actively involved in business etc., will lose mobility over a period of time and will have compromised functions leading to reduced productivity.

I have seen lot number of patients, who wait for Total Knee Replacement out of fear, and then come to me with Hip fractures. By unnecessarily waiting for Total Knee Replacement (out of fear), they developed loss of function and loss of balance of legs, and had a fall during activities of daily living !!!!

5. Development of excessive unwanted bone around the Knee (called as Osteophytes): With the passage of time, over years, one develops osteophytes growths around bones of the knee. If it occurs, you are no more candidate for Minimally Invasive Total Knee replacement, and you have missed the Bus !!!

Large Osteophytes with severe Deformity of Knee in a lady, who waited 10 years for her knee replacement. She is no more a candidate for Minimally Invasive Total Knee Replacement

To summarize, unnecessarily delay of Total Knee Replacement Surgery may lead to more complex surgery, more technically challenging surgery, more soft tissue dissection, more post-operative pain & prolonged rehabilitation and recovery, and may even compromise long-term results of Total Knee Replacement.