Total Knee Replacement- Should I, or Shouldn’t I, that is the question…

When to get a total knee replacement?  Should I wait?  Who should I ask about it? What about a total hip replacement?  When do I know when I need surgery?  Can I wait?  Will my knee or hip worsen?

All these are appropriate questions when determining the “when, where, and why” behind getting and total knee or hip replacement.  As Physical Therapists we see the outcomes of these surgeries, we keep people from having to have them and we can assist you in determining the steps you need to take to choose the right path.

We have helped hundreds if not thousands of patients over the years and we usually use two primary factors in advising them for or against a total joint replacement.

First, is Function.

Most of us will have some level of pain in our major joints as we become more “experienced” in life.  The amount of pain primarily is determined by genetics and by what we have done to ourselves over the years.  Both of these factors increase our susceptibility to the ugly effects of our favorite nemesis- arthritis.  Although our weight plays a role in the pressure placed on our joints, genetics seems to play an even bigger role in the progress of arthritis and pain.

If you are finding that you are becoming less active or aren’t able to complete your normal daily activities and are limiting yourself due to your knee or hip pain, you need to see a professional.  Your physical therapist will help you determine if you need a referral to a surgeon or if simple exercises and stretches you can do at home are your ticket for recovery.

Second, is Deformity

Often with degeneration of our major joints, we begin to acquire deformity and alignment problems because of the joint breakdown.  You have have seen it before- a bowing out or bowing in of someone’s knees, or a more noticeable limp.

These changes are usually caused by pain and arthritis and if they continue without being addressed by your physical therapist or physician could cause even more damage to the other joints in your body.  For example, often we see people with low back pain in our clinic, and upon examination, their hip is the problem, their hip needs to be loosened up or replaced.  Their hip was causing abnormal stresses on the lower back.



Keys to remember:

  • See your physical therapist first
  • Are you functionally limited due to your pain or weakness?
  • Are you experiencing deformity or compensation because of your pain and weakness?

The worry about total joints is the intensity of the recovery, the length of the recovery, and the investment in time and energy that it will take.  The positive is that technology has changed, physical therapy has changed and the recovery has changed.  All have improved to deliver a better, faster, and less painful outcome if a total joint replacement is necessary.