Knee pain is a common complaint, especially among older adults or those with joint problems, such as osteoarthritis. In the early stages, this condition can generally be managed through medication, physiotherapy, lifestyle changes, and even joint injections. These various methods aim to reduce pain, maintain knee function, and slow joint damage.
However, as joint damage progresses, conservative therapy sometimes no longer provides optimal results. Pain persists, mobility becomes increasingly limited, and even simple activities like walking or climbing stairs become difficult. In these circumstances, doctors may consider Total Knee Replacement (TKR) as a treatment option.
So, what are the reasons why TKR is necessary and when is this operation really necessary?
Why Doesn't Knee Pain Treatment Always End in Surgery?
Not all knee pain requires surgery. In fact, most patients will undergo conservative therapy first, as surgery is not the first treatment option.
Some of the methods commonly used include:
- Take painkillers or anti-inflammatory drugs as directed by your doctor.
- Physiotherapy program to increase muscle strength around the knee.
- Physical exercises tailored to the patient's condition.
- Lose weight to reduce the load on the knee joints.
- Use of walking aids if necessary.
- Joint injections, such as corticosteroids or hyaluronic acid, in certain conditions.
The primary goal of conservative therapy is to reduce pain, maintain joint function, and slow the progression of damage. Throughout therapy, the doctor will assess whether symptoms are improving or worsening. If these therapies are no longer effective, surgery may be considered.
What Conditions Make Total Knee Replacement an Option?
Not all patients with osteoarthritis require knee replacement surgery. The decision to undergo a total knee replacement is based on a combination of symptoms, examination results, and the patient's quality of life.
Some of the reasons why TKR needs to be carried out include:
1. Persistent knee pain that interferes with activities
The pain occurs almost every day, making it difficult for the patient to walk, stand for long periods, go up and down stairs, or perform other routine activities.
2. Pain persists while resting
In severe joint damage, pain not only occurs during activity, but also when sitting, lying down, and even disrupts sleep at night.
3. The knees become stiffer and harder to move.
Cartilage damage can lead to a limited range of motion in the knee. The knee may feel stiff, difficult to bend or straighten, and may even become deformed.
4. The examination results show severe joint damage.
The doctor will perform a physical examination and additional tests, such as an X-ray, to assess the extent of joint damage. If the cartilage has been extensively damaged, causing the bones to rub together, surgery may be a more effective option.
5. The benefits of surgery are considered greater than conservative therapy.
The final decision still takes into account the patient's overall condition, including age, activity level, comorbidities, and the patient's expectations regarding quality of life after the procedure.
What is the Purpose of Total Knee Replacement for Patients?
Total Knee Replacement is a surgical procedure that replaces the damaged knee joint surface with an artificial implant. The primary goal of this procedure is not only to address joint damage but also to improve the patient's quality of life.
Some of the expected benefits include:
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Reducing chronic pain
The damaged joint surface is replaced with an implant so that friction between the bones can be significantly reduced.
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Improve knee function
Patients are expected to be able to walk, stand, climb stairs, and perform daily activities more comfortably after the recovery period.
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Improve quality of life
When chronic pain has already hampered mobility and independence, surgery can help patients return to their normal activities.
It's important to understand that the success of a total knee replacement doesn't depend solely on the surgical procedure. A medical rehabilitation program, physiotherapy, regular exercise, and patient adherence to doctor's recommendations play a crucial role in the recovery process.
What Do You Need to Prepare Before Undergoing Total Knee Replacement?
Before undergoing surgery, the doctor will conduct a thorough evaluation to ensure the patient is in good enough condition to undergo the procedure.
Preparations that are usually carried out include:
- Comprehensive health check.
- Blood tests as needed.
- X-ray of the knee to assess the condition of the joint.
- Heart examination or other examinations if there are accompanying illnesses.
- Controlling chronic diseases such as diabetes or hypertension.
- Maintain body weight so as not to put excessive stress on the knees.
- Start light exercises to strengthen the muscles around the knee as directed by a physiotherapist.
Optimal preparation can help smooth the surgical process and support recovery after the procedure.
When Should You See a Doctor About Knee Pain?
Immediately get checked if you experience the following conditions:
- Knee pain does not improve despite undergoing treatment or self-care.
- The knees feel increasingly stiff so that daily activities begin to be disrupted.
- Pain occurs when resting or waking from sleep at night.
- The knee often becomes swollen, deformed, or feels unstable when walking.
- Simple activities such as walking, standing, or climbing stairs become increasingly difficult.
If you're experiencing persistent knee pain, don't hesitate to consult an orthopedic and traumatology specialist. Through a thorough examination, your doctor can determine whether conservative therapy is still the best option or whether a total knee replacement is necessary, depending on your joint condition and needs. The orthopedic and traumatology specialists at EMC Hospital are ready to assist with the appropriate evaluation and treatment so you can return to your daily activities more comfortably.
Article written by Dr. Othdeh Samuel, Sp.OT, FICS, Subsp PL (K), AIFO-K (Orthopedic & Traumatology Specialist, Hip & Knee Subspecialist, EMC Pekayon & Cibitung Hospital).