Is it time for a knee replacement? Understand your options
Knee pain can make it hard to complete even the simplest of tasks. Determine if a knee replacement is right for you with guidance from our experts
What is a knee replacement?
A knee replacement procedure restores injured or worn-out joints within the knee by replacing damaged bone and cartilage with metal and plastic implants. At University of Iowa Health Care, there are three approaches to knee replacement:
- Partial knee replacement is where the damaged area of the joint is replaced with implants while the healthy bone, cartilage, and ligaments are left intact.
- Total knee replacement is where the entire joint, including the kneecap and cartilage, is replaced with an artificial joint.
- Robotic-assisted joint replacement is where robotic tools and 3D planning assist the surgeon in precisely removing and replacing damaged bone while protecting the healthy areas within the knee.
Who may need a knee replacement?
An orthopedic care team will evaluate the state of the knee joint and determine if a replacement procedure is necessary. Before recommending knee replacement surgery, your team will look for key indicators, such as:
- Radiographic evidence of end-stage arthritis must be present on imaging.
- The patient must experience functional limitations that affect daily life or quality of life on most days.
- Conservative treatments (e.g., medication, physical therapy, injections) must have been attempted and proven ineffective for long-term relief.
- The patient must be in good enough health to safely undergo surgery.
While each person is different and has varying levels of pain and range of motion, there are common symptoms that may suggest you could benefit from a replacement:
- Advanced arthritis or deformity of the knee
- Severe swelling of the knee
- Severe stiffness in the knee
- Significant instability
- Changes in daily activities due to knee pain
"In the knee and the hip, the pain is activity-related and often gets worse during the day," says Nicolas O. Noiseux, MD, MS, FRCSC, an orthopedic surgeon at UI Health Care specializing in hip and knee replacements.
Knee specialists will often discuss your knee pain during a consultation appointment and request X-rays or MRIs of the knee to determine if a knee replacement is suitable. Other treatment options could help relieve less severe pain, such as:
Anti-inflammatory or pain medication
Cortisone injections
Regenerative medicine, like PRP injections.
What causes chronic knee pain?
While chronic knee pain can present itself differently from person to person, the cause of the pain is often a good way to determine the severity of the injury or condition and if it will need intervention, like an arthroscopic repair or knee replacement.
Common causes of chronic knee pain include:
- Injury such as a fracture, torn meniscus, or patellar tendinitis
- Hypermobility
- Damage to your hip joint or foot
- Types of arthritis such as osteoarthritis
Chronic pain that requires a knee replacement is often caused by repeated damage and stress to the cartilage, forcing it to gradually wear away. Knee replacement specialists and orthopedic teams frequently see patients enter their operating rooms due to osteoarthritis or problems with the formation of the knee joint.
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Is it time for a knee replacement?
Chronic knee pain can be treated without surgery in several ways, commonly starting with physical therapy to strengthen the surrounding muscles and help support the weakened joint.
"There are two treatments for arthritis. We always start with the nonoperative options," says Noiseux. "If the nonoperative treatments have been tried and failed and there's still a lot of disability, progressing to surgical treatment is based on the level of disability and pain near or at bone-on-bone arthritis or advanced arthritis changes on the X-ray."
However, when the damage to your knee begins to restrict daily activities and tasks, halt your knee's full range of motion, or cause debilitating pain, a knee replacement may be your best option for relief.
What are the benefits of a knee replacement?
A knee replacement could provide you with numerous benefits, including:
- Pain relief
- Improved mobility
- Less dependence on mobility devices like a walker or cane
- A healthier lifestyle with more frequent physical activity and less pain with daily tasks
Our expert team will thoroughly assess your knee and overall health to create a personalized treatment plan that fits your needs. If you're considering knee replacement, we're here to guide you through every step.