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Knee Replacement Surgery in Older People- Risks and Alternatives

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Knee replacement surgery has proved to be a boon for elderly individuals. Read the article below to learn in detail about them.

Medically reviewed by

Dr. Rajesh Gulati

Published At March 10, 2023
Reviewed AtMarch 10, 2023

Introduction:

Replacement surgeries are opted to restore function and relieve pain that has affected joints. Elderly individuals with osteoarthritis are offered surgery as a potential treatment option because of associated risks. A well-built communication between the healthcare providers and patients may allow more informed choices for the elderly patient and thoughtfully weigh the risks and burdens of joint replacement surgery against benefits like improving quality of life and alleviating pain.

What Is Knee Replacement Surgery?

Knee replacement is, also known as arthroplasty, one of the most successful and standard procedures available, and it has improved millions of people's lives. The primary reason to have the surgery is to cure severe osteoarthritis that causes severe pain and swelling and keeps individuals from doing regular activities. Many elderly people think knee replacement surgery does not provide enough benefits, as it is a matter of debate. Around 50 percent of the individuals successfully underwent the procedure and had positive outcomes, while the rest did experience some side effects and prolonged pain, even after surgery.

What Symptoms of Knee Pain Lead To Knee Replacement as the Only Option?

The symptoms of knee pain that decide on knee replacement surgery are:

  • Severe knee pain that hinders day-to-day activities.

  • Long-lasting knee inflammation and swelling that does not get better on medication or rest.

  • Moderate to severe pain day and night.

  • A bowing in or out legs.

  • Knee stiffness.

  • Knocking sound around knees while walking.

  • No pain relief from over-the-counter medication.

  • X-rays reveal bone touching bone around the knee.

Who Is the Best Candidate for Knee Replacement Surgery?

Knee pain and arthritis can get worse over time. Despite medications, home remedies, and treatment, if the pain persists, it may be the right time to go for a knee replacement option. Knee replacement is a major procedure, but it can offer better life quality and improve mobility that lasts for many years. The knee replacement is more of a resurfacing of bones in the knee. Surgeons remove bony surfaces and replace them with metal and plastic implants. This serves the same purpose as cartilage and helps implants glide each other. The ideal candidates for knee replacement surgery are:

  • Increased knee pain can hinder day-to-day activities.

  • Inflammation - Increased knee swelling and inflammation that does not get better with rest or medication.

  • Failure of other treatments.

  • Knee abnormality.

  • Any trauma to the knee.

The individual's overall health is considered before deciding the right candidate for knee replacement. Conditions like:

  • Diabetes: A test is needed to determine blood sugar levels so that they are in control during the procedure.

  • Heart Conditions: The healthcare provider may require to work with a cardiologist during surgery and recovery if any heart condition persists

  • The intake of over-the-counter medications and supplements should be informed to the surgeon. Advice and suggestions are required on the medication taken before and after surgery.

  • Family and Social Support: Recovery is central to the joint replacement process. Family and social support are required to have an emotional bond and a happy atmosphere to encourage positivity.

  • Muscle Strength: Recovery from a joint replacement is made by specific exercises and physical therapy plans. Physical therapy is dependent on enough strength of muscles that helps in recovery.

What Are the Risks of Knee Replacement Surgery in the Elderly?

The risks associated with knee replacement in the elderly are relatively less. Around 8 percent of individuals over 65 years of age underwent knee replacement surgery and experienced a complication.

  • The most common complication is a reaction to anesthesia which is nausea and vomiting after the surgery.

  • Adverse reaction to anesthesia is reduced as long as one discloses all drugs and medications taken by the individual before surgery.

  • Blood clots are possible complications after the surgery. They are scary but preventable. If the individual is taking blood thinners, they should be informed to the surgeon before surgery so necessary precautions are taken.

  • Clots can be reduced with the support of lower leg exercises, increased blood circulation with legs elevated, and support stockings.

  • Other risks are allergic reactions and infection.

What Are the Alternatives to Knee Replacement Therapy in Elderly People?

If an elderly patient is not eligible for knee replacement therapy or is not ready to invest in therapy. The other options that can reduce pain and increase movement are:

  • Improvement with exercise.

  • Weight Loss - This helps in reducing less force pressing on the knees.

  • Low-impact exercises like tai-chi and yoga can ease the pain in the elderly.

  • Physical therapy.

  • Pain medications.

  • Steroid injections.

  • Acupuncture.

  • A less invasive arthroscopic surgery helps to remove bone fragments and repair cartilage.

What Is the Other Option for Knee Pain Other Than Knee Replacement Surgery in the Elderly?

The other options for knee pain include the following:

  • Injections for Knee Pain: Hyaluronic injections can help lubricate the inner working of the knee and relieve pain. There is less evidence that supports the benefits of PRP (platelet-rich plasma) and concentrated stem or bone marrow cells.

  • RFA (Radiofrequency Ablation) For Knee Pain: RFA controls pain in knees by destroying sensory nerves that carry pain signals from the knee to the brain. It is a procedure that gives temporary relief, and nerves get back by six to two years, and the pain returns.

  • Cartilage Regeneration: ACI (autologous chondrocyte implantation) involves taking a sample of cartilage cells that are laboratory grown and surgically implanted in the knee.

Conclusion:

Knee replacement surgery is a standard procedure thousands of individuals undergo yearly. Many of them face no complications. It is essential to know the risk and spot the signs of complications. This may help to make an informed decision about whether to further move on with the procedure or not. This will also equip them to take action if any complication or problem arises. There are many constant innovations in the field of knee replacement. Many surgeons use regional anesthesia for the procedure, which can mean having a shorter hospital stay with general anesthesia. In addition, new multimodal pain approaches, physical therapy, and surgical techniques improve individuals' knee replacement experience.

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Dr. Rajesh Gulati
Dr. Rajesh Gulati

Family Physician

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knee replacement surgery
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