Knee replacement surgery, also known as knee arthroplasty, is a procedure where damaged surfaces of the knee joint are replaced with artificial components. It is typically necessary for patients experiencing severe, chronic knee pain and dysfunction due to progressive arthritis, injury, or other degenerative conditions. The surgery aims to relieve pain, correct leg deformity, and improve knee function.
The dangers of delaying knee replacement surgery are increased pain, loss of mobility, cardiovascular risks, weight gain, slower recovery, and other complications. The ideal timing for knee replacement is crucial, as a worsening knee can make the procedure more difficult and less optimal. Understanding these risks and negative effects is essential for successful knee replacement.
What is Knee Joint Replacement Surgery?
Knee joint replacement surgery is a procedure in which a damaged or diseased knee joint is replaced with an artificial joint or prosthesis. The procedure involves removing the damaged portions of the knee joint, including the end of the femur (thigh bone) and the top surface of the tibia (shinbone), and replacing them with metal, plastic, or ceramic components that mimic the shape and function of a healthy knee joint.
Knee joint replacement surgery aims to relieve pain, restore mobility, and improve overall knee function for individuals with severe knee arthritis, injury, or other conditions affecting the knee joint.
The Need for Knee Replacement Surgery
Knee replacement surgery is often necessary when someone suffers from chronic knee pain and loss of mobility due to conditions like osteoarthritis or rheumatoid arthritis.
- Osteoarthritis, the wearing down of cartilage in the joints over time, is one of the most common reasons for knee replacement. Osteoarthritis is a progressive disease that causes stiffness, swelling, and pain that worsens over time.
- Rheumatoid arthritis, an autoimmune disorder that attacks the joints, can also severely damage the knees and require replacement.
Pain and Loss of Mobility: People seeking knee replacement surgery often suffer from severe, debilitating knee pain even while at rest. Their knees may be inflamed, tender, and swollen. Standing or walking even short distances becomes difficult or impossible due to pain and loss of mobility.
Best Option to Restore Function: Many pursue alternative treatments like steroid injections, physical therapy, knee braces, or anti-inflammatory medications in hopes of avoiding surgery. However, when these provide only temporary relief or fail, knee replacement becomes the best option to restore function and improve quality of life.
Surgery removes damaged bone and cartilage and resurfaces the joint with an artificial implant. For appropriate candidates, knee replacement can effectively relieve pain and restore mobility.
Dangers of Delaying Knee Replacement Surgery
Delaying a needed knee replacement surgery can lead to several problems that often compound and worsen over time.
- Increasing Pain and Loss of Mobility: As the knee joint continues to deteriorate, patients experience increasing pain and loss of mobility. Simple activities like walking, standing up from a chair, or going up and down stairs become exceedingly difficult.
- Impact on Cardiovascular Health & Weight Gain: The constant pain and immobility also take a toll on overall cardiovascular health. Without being active, patients can gain a significant amount of weight. Obesity puts further strain on the knees and heart. Patients may find walking or exercise nearly impossible. This lack of physical activity increases the risks of heart disease, high blood pressure, diabetes, and stroke.
- Delayed Surgery Resulting in Dificulity in Recovery: Postponing surgery also means the knee damage continues to worsen. This can lead to slower and more difficult recovery after knee replacement surgery finally takes place. The more diseased the joint, the longer rehabilitation will take.
- Complications During & After Surgery: Delaying too long also increases the chances of complications during or after surgery. Potential issues include excessive bleeding, blood clots, nerve injury, implant failure, stiffness, and loss of range of motion. The surgery becomes more complicated with more diseased tissue to remove and repair.
Overall, putting off a knee replacement surgery causes increased chronic pain and disability. It puts patients at higher risk for cardiovascular problems, obesity, and surgical complications. Timely knee replacement surgery is recommended to halt joint deterioration and restore mobility and quality of life.
Psychological Effects of Delaying Surgery
Delaying knee replacement surgery can significantly impact patients psychologically. As mobility decreases due to worsening knee pain and stiffness, patients can experience depression and a reduced quality of life.
Depression Due to Reduced Mobility
Limited mobility often leads to depression in knee replacement candidates. People who cannot walk, exercise, or engage in regular physical activities may experience isolation, low self-esteem, and a lack of independence. This can contribute to feelings of sadness, worthlessness, and hopelessness characteristic of depression. Studies show depression rates in people with severe knee osteoarthritis are as high as 20%.
Importance of Timing Surgery Appropriately
Getting knee replacement surgery at the optimal time is crucial. Doctors should carefully determine the best timing for surgery to maximize mobility benefits and quality of life.
Patients who delay too long can develop chronic depression from reduced mobility. On the other hand, patients who get knee replacements too early may require revision surgery later on.
Lower Quality of Life
Without surgery, patients’ quality of life progressively worsens. Daily tasks like walking, standing up, or using stairs become difficult or impossible. This can lead to loss of independence, social isolation, and inability to work or engage in leisure activities. Timely knee replacement can dramatically improve quality of life by reducing pain and restoring mobility.
Potential Complications and Risks
Higher surgical risks with advanced joint damage
Delaying knee replacement surgery can result in advanced joint damage, which can increase the surgical risks and complications. As the joint deteriorates further, surgical intervention becomes more complex. The surgical procedure may involve more extensive bone and soft tissue removal, leading to a longer and more challenging operation.
Additionally, the weakened joint structures may make it harder to achieve optimal implant positioning, potentially affecting the overall success and longevity of the replacement.
Increased likelihood of post-surgical complications
Prolonging the need for knee replacement surgery can heighten the risk of post-surgical complications.
- Longer Recovery Period & Infections: Delayed surgery can contribute to a longer recovery period and may increase the likelihood of developing postoperative infections. The weakened joint and surrounding tissues may be more susceptible to infection, requiring more aggressive treatment, such as prolonged antibiotic therapy or revision surgery.
- Blood Clots in Legs: Furthermore, delayed knee replacement surgery can lead to a higher incidence of blood clots (deep vein thrombosis) in the legs. Reduced mobility due to pain and joint dysfunction can contribute to blood stasis, increasing the risk of clot formation. Blood clots can potentially travel to the lungs and cause a life-threatening condition called pulmonary embolism.
- Stiffness, Nerve Damage, and Pain: Other potential complications associated with delayed knee replacement surgery include stiffness, delayed wound healing, nerve damage, and persistent pain. The longer the joint remains dysfunctional, the more likely these complications may arise and impact the patient’s overall recovery and outcome.
Available Treatment Options
Non-surgical interventions for pain management
When knee replacement surgery is delayed, various non-surgical treatment options can help manage pain and improve knee function. But it is not advised without proper consultation, because it can get worse with time. These may include:
- Medications: Over-the-counter pain relievers such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) can help alleviate pain and reduce inflammation. Prescription medications, such as corticosteroids or hyaluronic acid injections, may also be considered for symptom relief.
- Physical therapy: A physical therapist can develop a customized exercise program to strengthen the muscles around the knee joint, improve flexibility, and enhance overall function. Physical therapy may include exercises, stretches, and ultrasound or electrical stimulation modalities.
- Assistive devices: Using assistive devices like canes, crutches, or knee braces can provide support, reduce joint stress, and improve mobility.
Rehabilitation and physical therapy
Rehabilitation and physical therapy are crucial in managing knee pain and improving function, both before and after knee replacement surgery. Physical therapy can help maximize joint mobility, strengthen muscles, and enhance overall stability. A therapist will guide patients through exercises, stretches, and functional movements to improve their range of motion, reduce pain, and increase strength.
Importance of assessing surgical candidacy with a healthcare professional
While non-surgical interventions can provide temporary relief, they may not address the underlying joint damage and deformity that necessitates knee replacement surgery. It is crucial to consult with a healthcare professional, such as an orthopedic surgeon, to assess surgical candidacy. The surgeon will evaluate factors such as the severity of joint damage, pain levels, Functional limitations, and overall health to determine if knee replacement surgery is the appropriate course of action.
Knee replacement surgery decisions should be individualized, and consult with a healthcare professional for personalized advice, discussing benefits and risks, and determining the most suitable treatment approach.
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Conclusion
Knee replacement surgery can significantly improve the quality of life for patients with severe knee arthritis and joint damage. However, delaying the procedure can lead to negative health consequences, such as worsening pain, loss of mobility, weight gain, cardiovascular issues, and mental health problems. It’s crucial to undergo knee replacement at the right time for optimal results, allowing patients to return to daily activities pain-free.
Beth is Cloudmineinc’s senior health editor and a certified personal trainer. She has over 10 years experience as a science journalist and is the author of two books. She deadlifts over 315 lbs.