Knee replacement surgery can relieve pain and restore mobility in the knee. There are various reasons why you might need a knee replacement, but the most common is osteoarthritis (OA) of the knee.
OA of the knee causes the cartilage to gradually wear away in your knee. Other reasons for surgery include an injury or having a knee problem from birth.
If you’re considering a knee replacement surgery, the first thing you will need is a medical evaluation. This is a multi-stage process that will include examinations and tests.
During the evaluation, you should ask your healthcare provider plenty of questions about the procedure and the recovery process. This information will help you determine if knee replacement surgery is the right treatment for you.
Your doctor may also encourage you to try alternative options first, including lifestyle changes such as exercise and weight loss.
The evaluation process will involve:
- a detailed questionnaire
- a physical evaluation
- a consultation about the results
According to the American Academy of Orthopaedic Surgeons, 90 percent of people who have knee replacement surgery say they have much less pain after surgery.
However, surgery can be costly and time-consuming, and recovery can take up to 6 months or a year.
This is why it’s important to think carefully before going ahead.
Here are the steps of the evaluation process:
A detailed questionnaire will cover your medical history, pain level, limitations, and the progression of your knee pain and problems.
Questionnaires may vary by doctor and clinic. They typically focus on whether you’re able to:
- get in and out of a car
- walk without a limp
- walk up and down stairs
- sleep at night without pain
- move without your knee feeling as if it’s going to “give way” at any given moment
The questionnaire will also ask about your overall health and any existing conditions you may have, such as:
Your doctor will also want to know how any of these conditions have changed recently.
It’s important to mention any health problems during your evaluation, as some conditions, such as diabetes, anemia, and obesity, can impact the treatment choices your doctor suggests.
This information will enable your doctor to:
- diagnose your knee problems
- determine the best treatment approach
Next, they will carry out a physical evaluation.
During the physical exam, your doctor will measure your knee’s range of motion using an instrument that resembles a protractor.
- extend your leg in front to determine the maximum extension angle
- flex it behind you to determine the maximum flexion angle
Together, these distances make up your knee’s range of motion and flexibility.
Your doctor will also check your muscle strength, mobility, and knee position.
For example, they will look to see if your knees are pointing outward or inward.
They will assess these while you are:
- taking steps
- performing other basic activities
An X-ray provides information about the health of the bone in your knee. It can help the doctor decide if a knee replacement is a suitable option for you.
If you have had previous X-rays, bringing these with you will enable the doctor to measure any changes.
Some doctors also request an MRI to get more information about the soft tissues around your knee. It can reveal other complications, such as infections or tendon problems.
In some cases, the doctor will extract a fluid sample from the knee to check for an infection.
Finally, your doctor will discuss your options with you.
If your evaluation shows severe damage and other treatments are unlikely to help, the doctor may recommend knee replacement surgery.
This will involve removing damaged tissue and implanting an artificial joint that will work in a similar way to your original knee.
The evaluation is a long and thorough process, and you will have plenty of chances to ask questions and raise concerns.
Here are some questions you may like to ask:
- What are the alternatives to surgery?
- What are the pros and cons of each alternative?
- Will you perform traditional surgery or use a newer method?
- How large will the incision be and where will it be located?
- What risks and complications might there be?
- How much will knee replacement reduce my pain?
- How much more mobile will I be?
- What other benefits am I likely to see?
- How will my knee function in the future if I don’t have surgery?
- What problems are likely to occur?
- What activities will I be able to resume after surgery?
- Which activities will no longer be possible?
Surgeon expertise and safety
- Are you board-certified and have you served a fellowship? What was your specialty?
- How many knee replacements do you do a year? What outcomes have you experienced?
- Have you had to do revision surgery on your knee replacement patients? If so, how often and what are the typical reasons?
- What steps do you and your staff take to ensure the best possible outcome?
- How long should I expect to be in the hospital?
- Are you available after surgery to answer questions and address concerns?
- At which hospital or clinic will you perform the surgery?
- Is knee replacement a common surgery at this hospital?
Risks and Complications
- What risks are associated with this procedure?
- What type of anesthesia will you use, and what are the risks?
- Do I have any health conditions that would make my surgery more complicated or risky?
- What are the most common post-surgery complications?
- Why are you choosing the prosthetic device you’re recommending?
- What are the pros and cons of other devices?
- How can I learn more about the implant you are selecting?
- How long will this device last?
- Have there been any previous problems with this particular device or company?
Recovery and Rehabilitation
- What is the typical recovery process like?
- What should I expect and how long will it take?
- What does the typical rehabilitation involve?
- What extra help should I plan for after leaving the hospital?
- How much will this procedure cost?
- Will my insurance cover it?
- Will there be any extra or hidden costs?
Knee replacement is effective at relieving pain, restoring flexibility, and helping you live an active life.
Surgery can be complex, and recovery can take time. That’s why an in-depth evaluation process is essential.
Be sure to ask your doctor lots of questions during the evaluation, as this will help determine if this surgery is the right treatment for you.