May 25, 2011

Knee Trouble

For a year now I have had problems with my knee. When the pain started, I was told that an MRI showed a torn semilunar cartilage. The surgeon shaved the cartilage via arthroscopic surgery, but the pain continued. Now the specialist tells me that the knee has osteoarthritis. I’m limping badly, have had injections in the knee, and keep exercising in the swimming pool. Last week I was told I should consider knee replacement.
 
My work requires me to do a fair amount of walking. I am in my 60s. What do you suggest?
 
Chronic joint pain not only impairs movement but may begin to influence your whole outlook on life. These days, a 60-year-old is really in the “new middle age,” because life expectancy for most is another 20-plus years. Presumably, because you are working and swimming, you are in fair general health.
 
Joint replacement can be used for several joints, but the most frequently replaced are the hip, knee, and shoulder joints.
 
2011 1515 page23An interesting point is that patient satisfaction with the procedure is as dependent upon expectations as on the mechanical function of the joint. About 95 percent of the operations are technically successful. The majority see great improvement in both joint mobility and pain relief. Researchers at the Toronto Western Hospital in Canada reported that patients with realistic preoperative expectations were very satisfied with the procedure (Journal of Arthroplasty, August 2009). There are patients who become so obsessed with pain that their tolerance falls, and their postoperative recovery may be compromised by their pain tolerance. Most patients experience significant improvement, but not immediately.
 
The actual surgery will take about two hours, probably followed by a few days in the hospital. Physical therapy will be required for several weeks, and most people will take three months to recover. For others, it’s six to 12 months before they feel normal.
 
While the goal is to achieve normal daily function, this doesn’t mean you’ll be able to do things that have always been beyond your ability. If you have expectation of the ability to walk, climb stairs, and function as average folk of your age, you will likely be very satisfied.
 
Everyone undergoing surgery needs to understand the potential for complications. A failure of the joint to function properly might be a result of your bone structure, healing capacity, and prior muscular conditioning. Infection, an ever-present risk, can be especially problematic if it occurs in bone. These risks, however, are not statistically high.
 
If you have consulted with more than one physician and they both agree on your needing a knee replacement, I would think the operation will likely bring you significant improvement.
 
The newer replacement joints are a vast improvement over the first models, but even so, they have a limited life span. For all our engineering technology, there is nothing that compares to the designs of the Ultimate Designer. It’s unlikely a knee replacement will function properly for more than 20 to 25 years. Of course, how much you use and/or abuse it is also important. Although for healthy people we encourage walking as a good form of exercise, resistance training in the gym and swimming are probably preferred to excessive walking and running on an artificial joint.
 
________
Send your questions to Ask the Doctors, Adventist Review, 12501 Old Columbia Pike, Silver Spring, Maryland 20904. Or e-mail them to [email protected]. While this column is provided as a service to our readers, Drs. Landless and Handysides unfortunately cannot enter into personal and private communication with our readers. We recommend you consult with your personal physician on all matters of your health.
 
_____________
Allan R. Handysides, a board-certified gynecologist, is director of Health Ministries for the General Conference. Peter N. Landless, a nuclear cardiologist, is an associate director of Health Ministries for the General Conference. This article was published May 26, 2011.

 

Advertisement
Advertisement