It goes without saying that the decision to undergo a total knee replacement procedure is a decision not to be taken lightly, and there is a lot to think about before taking the plunge.
For many, it is uncertainty about the recovery period and its implications that play a role in making this decision: roughly six weeks before being able to resume a normal life, and anything from four months to a year to fully recover and feel the full benefit of the surgery. Consequently, many people are inclined to put off the procedure for as long as possible.
However, a report published in the Journal of Bone and Joint Surgery recently spelt out that knee replacement timing is everything. Leave surgery too late, and you run the risk of not reaping the full benefits of the procedure. Conversely, have it too soon and you may run into complications and ever require another replacement.
The study, conducted by the Feinberg School of Medicine at Illinois’ Northwestern University, deployed an algorithm that incorporates joint function, pain, radiographic assessment, and age to best determine the optimal time to have a knee replacement. It was based on information from 8,002 people who had or were at risk for osteoarthritis, who were followed up on for up to eight years.
According to the report, a lack of timing – and its knock-on effects – is rife. Around 90 per cent of patients with knee osteoarthritis are waiting too long to have the procedure, while 25 per cent of people who don’t yet need it are having the procedure done too soon, and consequently only experiencing minimal benefits.
Knee replacement timing: what’s the problem with waiting too long?
Well, while you’re waiting for the most convenient time to have your knee done, osteoarthritis doesn’t hang about. As it continues to flourish, the function of the affected area continues to deteriorate, which can impact upon exercise and activity, which inevitably leads to knock-on effects, both physical and mental. Not only that, but the longer they leave it, the less function will be restored when the procedure actually happens, and mobility levels are reduced considerably compared to those in patients who had the procedure done in a timelier fashion.
Knee replacement timing: what’s the problem with going too early?
Patients who have surgery too soon ramp up the risk of developing complications and increase the chances of having to undergo revision surgery somewhere down the line. And as any surgeon will tell you, revision surgery procedures can be more difficult, and often result in poorer outcomes.
While the researchers are more than aware that many people can’t just drop everything and go under the knife at the perfect moment, their hope is that their algorithm can be honed and adopted by the wider medical community to give future TKR patients the clearest advice for the best possible outcome.
To discuss your knee replacement options in more detail, call either our London or Bristol knee clinics: