Considerations for Total Knee Replacement


Knee pain can be excruciating. The knee joint is a major weight-bearing joint that is often taken for granted until it is injured or affected by osteoarthritis. In March we will have a series of blogs about the knee. This first one talks about potential treatments your doctor may have you try in order to preserve your joint, rebuild the muscles surrounding the joint to prevent further injury or decrease your pain so you are not lead down the road to a knee replacement.

Each patient is going to have their own unique treatment plan based on the circumstances to their knee pain such as: Was there an injury, tear, knee dislocation, fracture to the bone, arthritis developed as a result of a previous injury or just arthritis due to age.

Several things have to be carefully considered when your doctor determines what is the best treatment plan for you. Some of those are, but not limited to, duration of pain, location and reason for the pain, mobility, pain level, age, physical activity level, BMI, other medical history, or social risk factors such as smoking.

Total joint replacement surgeries are usually the last resort for those suffering from knee pain. There are many options to try prior to your doctor even considering or recommending a replacement. Below we will explore those options that are less invasive that may prevent you from going down the road to surgery.

  1. Anti-inflammatories, analgesics or short-term narcotics for pain control – The choice your doctor may prescribe depends on many things such as the severity of your pain level, a reason for the pain ie. swelling due to injury or arthritis, and other health risk factors. Many times, doctors choose to give anti-inflammatories or analgesics for mild to moderate pain and reserve narcotics for those with severe pain.
  2. Physiotherapy or exercise – The best way to rebuild a knee or decrease the pain is to gain proper mobility and strengthen the muscles around it to support it from further injury or deterioration. Structured exercises to isolate the issue can be done through the recommendation of a physiotherapist.
  3. Knee brace or orthotic shoes – Keeping your knee stabilized with a brace or wearing special orthotic shoes can give you extra support.
  4. Ice, heat, gels/creams or elevation – Something as easy as icing and elevating your knee can help decrease swelling which will, in turn, decrease your pain level. Heat works well for pain as do non-steroidal anti-inflammatory creams or gels.
  5. Weight loss – Lifestyle changes such as weight loss can be incredibly important. All of your weight bears down on your knees so the healthier you are and within a normal BMI range, the less stress your knee has to endure.
  6. Smoking cessation – Smoking is a bad habit in general and has many serious known complications. When you have an injury, smoking will interfere with your recovery. Not only will it prolong the healing process, it may also cause additional inflammation making it more difficult to get the pain under control and have the necessary mobility to rehabilitate your knee.
  7. Cortisone injection – These injections can be useful for decreasing the inflammation and pain in the short term. Their effect wears off within a few weeks to 3 months and may need to be repeated as needed.
  1. Hyaluronic acid injections – Hyaluronic acid is a natural substance that can give the joint fluid its viscosity. These injections take about 8 weeks to have their full effect and will typically last for 24 weeks.
  2. Platelet-rich plasma injections – Many people, especially athletes, are familiar with this procedure due to Tiger Woods when he utilized it for his injured knee. The process involves drawing your own blood, centrifuging it down to get the platelet-rich plasma and injecting it back into the injured tissue. The hope is to stimulate and optimize your body’s natural ability to heal the injury.
  3. iOvera treatment – This treatment is a cold therapy that kills away targeted sensory nerves around the knee that prevent the nerve from sending pain signals to the brain. It is injected into the skin and will last about 6 months. Because this is not permanently damaging or killing the nerve, the nerve will regenerate and grow back over time so the process may need to be repeated.

Keep in mind that not every one of these treatment plans will be appropriate for you. Consideration should be given to all these factors during a consultation with an orthopedic specialist and it may be recommended you try many of them at the same time.

As we age our joints can get arthritis. It damages the bone and the cartilage, thus making it very painful to move. Severe arthritis is not reversible and the affected joint does not usually improve on its own. Keeping the knee healthy when this first starts is key to further degeneration.

All of these treatments may not be available in your province.  If you are in a situation like this and your doctor feels you could benefit from one of them, contact us and we will help you find a facility that can. or 877-344-3544

This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.

Health Vantis