Knee arthritis: when is it time to think about a knee replacement?

Osteoarthritis of the knee happens when the smooth cartilage that covers the ends of the bones wears away. Bone begins to rub on bone, causing pain, stiffness and swelling. It is very common after the age of fifty, especially in women and in people who are overweight.

Start with the simple treatments

In early and moderate arthritis, many people stay active for years with the right combination of:

• Weight loss, which reduces the load on the knee with every step
• Physiotherapy to strengthen the thigh muscles that support the joint
• Pain-relief medicines used carefully, under a doctor's advice
• A walking stick in the opposite hand on bad days
• Avoiding deep squatting and sitting cross-legged on the floor when they cause pain

Signs a knee replacement may help

• Pain that stops you walking even a short distance
• Pain at night that wakes you or keeps you from sleeping
• Difficulty climbing stairs or getting up from a chair
• A knee that is becoming bow-legged or knock-kneed
• Little or no relief from medicines and physiotherapy

An X-ray shows how much cartilage is left. Surgery is considered when the X-ray shows advanced wear and the pain is limiting your life, not because of the X-ray alone.

What happens in a knee replacement

The worn surfaces of the knee are removed and replaced with smooth metal and medical-grade plastic components. Most patients stand and take their first steps with support within a day or two of surgery.

Recovery

Physiotherapy is the most important part of recovery. Most people walk independently within a few weeks and return to normal daily activities over two to three months. Regular exercise keeps the new knee working well for many years.