When must a person undergo knee-replacement surgery? A doctor answersDr.Kaushal Malhan
Total Knee Replacement or TKR is an operation for the end stage severe arthritis of the knees, says the doctor
When it comes to the body, most people take it for granted and deliberately push their doctor appointments, while knowing fully well they need the check-up. When this happens, an already-existing health issue may aggravate, causing them more inconvenience. Among other things, bone health becomes extremely vital after a certain age, and doctors advise their patients to get themselves checked.
According to a study published in the Journal of Bone and Joint Surgery, a vast majority of patients — who would benefit from knee replacement — are taking too long to have a surgery, to the detriment of their mobility and overall health, points out Dr Kaushal Malhan, director orthopedic surgery, Fortis Hospital, Mulund. “The study also showed delayed knee surgery has negative effects on post-operative recovery. During the COVID-19 pandemic, many patients delayed addressing their joint and bone problems; this proved to be even more detrimental,” he tells indianexpress.com.
Total Knee Replacement
Total Knee Replacement or TKR is an operation for the end stage severe arthritis of the knees. “It has the ability to correct not only the worn out surfaces, but also the mechanics, and hence providing a stable well-aligned joint. In spite of advancements in the procedure, some people hold on to outdated notions of its risks and outcomes, and delay it for as long as they can, which can potentially impact the post-operation function.
“The correct timing of surgery is essential to optimise results of the operation. So, the question that should be asked is: ‘Is it safe to delay knee replacement surgery, and for how long should one wait before committing to it?’”
What is knee arthritis?
Dr Malhan explains that it is a progressive disorder. The surface of the joint keeps getting abraded and bone loss occurs. This results in deformity. There is abnormal stress on the ligaments, too, which will gradually stretch out and lead to instability of the joint.
“A good primary TKR with healthy bone stock, stable ligaments and satisfactory joint alignment promises long-term success. Excessive delay may compromise the procedure affecting longevity of implants. There also may be risks in getting the surgery done too early,” he warns.
So what is the ideal time, and what should a patient keep in mind?
The doctor explains that while it may vary from person-to-person, some pointers ought to be considered:
1. It needs to be done when the knee problems significantly limit functions.
2. Before major deformity, bone loss and muscle atrophy sets in.
3. Earlier in patients with one good knee, so that it does not get affected because of the bad one.
4. Value of this surgery is greater when overall mobility and strength is satisfactory. No point in waiting till one is too old to undergo the surgery.
5. Do it before other age-related ailments prevent us from committing to the operation.
6. Earlier surgery in patients with deformity and joint instability.
7. Early if any condition predisposes to faster wear and tear of the joint.
8. People with progressive medical conditions which are under control may consider surgery before it is too late.
By Dr Kaushal Malhan, Director-Orthopedics and Joint Replacement, Fortis Hospital, Mulund