TKR Knee Replacement Surgery: What is it and when should you opt for it?
knee replacement surgery, TKR or knee arthroplasty is an open knee surgery where the articular surface of the knee is replaced. Total knee replacement surgery known as TKR is an option for a patient who has severe knee osteoarthritis or a knee injury in which the articular surface of their knee joint is damaged severely. Researchers throughout the world agree that the TKR (total knee replacement surgery) should be the last option. In other words, you must exhaust all your conservative approaches before opting for a TKR.
The Journal of Arthritis and Rheumatism published a study which reported a third of the total knee replacement (TKR) in the United States of America were inappropriate. The number one reason why it was reported as “inappropriate” was the fact that the majority of patients who obtained a TKR did so on a knee with mild or moderate osteoarthritis. The researchers related that knee replacement surgery should only be performed on patients that have severe osteoarthritis. According to researchers, the primary objective factor in a total knee replacement is the finding of severe osteoarthritis.
How long should you wait before opting for a TKR (knee replacement surgery)?
The decision to perform a total knee replacement surgery is not clear-cut, according to Dr. Jeffery Katz; professor of medicine and orthopedic surgery at Harvard Medical School in Boston. According to Dr. Katz, several parameters must be considered before opting for a total knee replacement surgery. The two most critical according to him are:
1). Patient must be in good preoperative health and function.
2). Delay to knee replacement surgery as the implant will eventually wear out.
He related that although advancements have improved the total knee replacement surgery the eventual wearing out of the implant is a concern, and as such the earlier one has a total knee replacement surgery, the greater the risk of implant failures in a recipient’s lifetime.
Should you have a TKR or Opt for Conservative Knee Treatment?
According to the lead researcher of a study published in November 2014 issue of The Bone and Joint Journal (Dr. Allen Riis); “a knee replacement surgery patient must have a gain or benefit from the expected knee replacement surgery. The title of this study published on November 4, 2014, in The Bone and Joint Jornal was “Low grading of the severity of knee osteoarthritis pre-operatively is associated with a lower functional level after total knee replacement.” Dr. Allen Riis’s research was a prospective cohort study with 12months’ follow-up. He related that patients might be better off to seek non-surgical means of treatments that improve knee pain and function. On the other hand, Dr. Katz describes that knee pain patients with severe osteoarthritis must weigh their options, as knee replacement surgery (TKR) is better done when one is in a good state of health.
The point both these highly acclaimed surgeons make is to opt for non-surgical methods first, and if the non-surgical means fail, you should delay the surgery. However, waiting too long may not be a good option if you are in your 60s or older. So, seek out clinical non-surgical treatment such as chiropractic and physiotherapy that target the knees holistically. Targeted methods of knee treatments through chiropractic, physiotherapy, rehabilitation and customized knee exercises can help the vast majority of patients who contemplate a TKR.
Who are the Best candidates for a TKR or Total Knee Replacement Surgery?
This is a tough question, but one needing an answer. The best answer we found was published in a research article in the Arthritis and Rheumatism Journal in 2013. According to this published research here are the best factors that bring about better outcomes in those that opt for total knee surgery or total knee replacement (TKR):
- Patients who suffer from severe to excruciating levels of pre-surgical pain.
- Knee Pain sufferers with ONLY one knee involvement.
- Patients with good overall health (meaning they don’t have other health conditions).
- Those with severe Osteoarthritis and no inflammatory disorders such as rheumatism
Can Knee Degeneration Lead to TKR Knee Surgery?
Degenerative changes in knees are the result of normal wear and tear with advancing age. But, for most, it is the product of excessive body weight, repeated injuries, and neglect. The human knee is an active joint encapsulated with ligaments for support and function. With an injury, the meniscus, ligaments, tendons, and muscles that control the function of the knee may get damaged. Knee degeneration can progress rapidly to the point-of-no-return with the continued neglect of mild or moderate knee pain and injury. In other words, a slight injury in time can become severe enough where a knee replacement may be warranted. However, knee degeneration is not enough of a criterion for a total knee replacement. Most degenerative knee conditions do respond favorably to customized conservative treatments.
Several criteria must be met such as severe knee degeneration, severe osteoarthritis, severe pain and severe limitation in mobility and function in addition to having an overall all good health. If one or more of these criteria is missing, you may be better with conservative treatment to aid complications after surgery.
Conservative Treatment Versus TKR Surgery
A randomized controlled trial conducted among 100 moderate-severe knee osteoarthritic patients over the span of 12 months. The researchers divided the group into two; patients who underwent the TKR surgery with 12 weeks of rehabilitation and another group who were treated conservatively with chiropractic, physiotherapy, nutritionists and dietetic care. The study found that the patients who underwent surgery felt a great reduction in their pain. However, in the long run, the TKR (knee replacement surgery) patients were suffered from more adverse effects as compared to the group who chose the conservative method.
People must understand that TKR surgeries are not a “go-to” option, but rather “I have no other choice” option. It lasts for 10-20 years so; wait until you are 65 or older. Undergoing a TKR at a young age can be very disabling towards your activities of daily living and can eventually be crippling. Opt for it if and only if you have to get it, and even then, get multiple medical opinions. Take care of your knees always go for the conservative approach initially. Your body will love you for it. Our centers offer the best knee pain treatment, visit us today and compare non-operative options to knee replacement surgery before you opt for TKR (knee replacement surgery).