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Jan
19

Knee Replacement Updates – Part 2 of 3

Dr. Mackarey's Health & Exercise ForumKnee Replacement Updates – Part 2 of 3

There is good news for those in need of a knee replacement today! Recent advances have led to equally viable options for two very different patient populations; the younger active patient and the older and less medically stable patient.

Recent studies conclude that knee replacement has had a very positive impact on lifestyle and overall health benefits for more than 7 million people in the United States that have had a hip or knee joint replaced. In view of this, it is predicted that this number will increase substantially with the aging baby boomer population.

Last week, in Health & Exercise Forum, Part I discussed knee arthritis and treatment options, including knee replacement. This week, Part II will offer a self-assessment to determine if you are ready or eligible for a new knee. Next week, Part III will present the benefits and complications of a new knee and will specifically discuss a new option in knee replacement surgery – partial or unicompartment knee replacement.

Who is Eligible for a New Knee?

Knee joint replacement is recommended for chronic, disabling arthritic knee pain not responding to conservative management such as: weight loss, activity modification, physical therapy, bracing, anti-inflammatory medication, pain killers, cortisone injections, viscosupplementation, arthroscopic debridement or osteotomy. Traditionally, a total knee replacement – TKR (also called a total knee arthroplasty – TKA) is recommended for 60+ year olds willing to eliminate high-impact activities (running, cutting, pivoting). Bicycling, swimming, golfing & walking are not usually restricted.

Today, however, there is good news for those in need of a knee replacement as recent advances have led to equally viable options two very different patient populations; the younger active patient and the older less medically stable patient.  According to Harry Schmaltz, MD, a local orthopedic surgeon specializing in joint replacement, new advances, such as the unicompartment or partial knee replacement (UKA), offer significant benefits to both young and old alike…it is not age dependent. The UKA will be discussed in more detail next week in “Health & Exercise Forum.”

 

New Research: Those Who Wait Too Long for New Knee Suffer From Other Health Problems

New research shows that those who suffer from knee pain due to arthritis for an extended period of time may be doing a great disservice to their overall health and well-being. The results showed that over time those suffering from advanced arthritis of the knee lose their ability to walk more than 1-2 blocks or climb stairs without severe pain. Also, they are unable to use a treadmill, bike, elliptical or stepper for aerobic exercise. As a result of this inactivity, they gain a significant amount of weight and are unable to enjoy traveling or doing things with their family due to the inability to walk. In addition to weight gain, a sedentary lifestyle leads to high blood pressure and sleep apnea. Over time, it is likely to lead to coronary artery disease and adult onset diabetes. Consequently, the arthritic pain in the knee can contribute to many health issues.

 

While surgery should never be taken lightly and is always the last option, sometimes it is the best choice.

How Do You Know if You’re Ready For A New Knee? Take the Test!

Score each question below as follows:

  • Extreme Difficulty or Unable to Perform = 0
  • Quite a Bit of Difficulty = 1
  • Moderate Difficulty = 2
  • A Little Bit of Difficulty = 3
  • No Difficulty = 4

Activities:

  1. Usual work, housework, daily activities (Score____)
  2. Hobbies, recreational activities, sports (Score____)
  3. Safely get in and out of a bathtub (Score____)
  4. Walking between rooms (Score____)
  5. Putting on shoes and socks (Score____)
  6. Squatting (Score____)
  7. Lifting objects (like a bag of groceries) from the floor (Score____)
  8. Performing light daily activities at home (Score____)
  9. Performing heavy activities at home (Score____)
  10. Getting in or out of a car (Score____)
  11. Walking 2 blocks (Score____)
  12. Walking a mile (Score____)
  13. Going up or down 10 stairs (Score____)
  14. Standing for one hour (Score____)
  15. Sitting for one hour (Score____)
  16. Running or walking fast on even ground (Score____)
  17. Running or walking fast on uneven ground (Score____)
  18. Making sharp turns while walking fast (Score____)
  19. Hopping or a skip step (Score____)
  20. Rolling or turning in bed (Score____)

TOTAL SCORE   _________/80

Scoring: The higher the score the more functional you are and less likely to need surgery for a new knee. For example, 80 out of 80 total points is normal. 60 and above is fairly functional. 40 to 50 points is a danger zone and below 40 you might start talking to your doctor about a surgery. Your orthopedic surgeon will help you decide if a total or partial knee replacement is best for you. Next week in “Health & Exercise Forum” in the Scranton Times-Tribune, read about the partial knee replacement.

SOURCES: Lower Extremity Functional Scale; American Physical Therapy Association; American Academy of Orthopaedic Surgeons; Biomet Inc.

Medical reviewer: Harry Schmaltz, M.D., orthopedic surgeon and joint replacement specialist, certified Oxford Unicompartmental Knee replacement surgeon, Scranton Orthopaedic Specialists, PC.