Myths and Facts on Total Knee Replacement (TKR)

By Dr. (Prof.) Anil Arora (Ortho) in Orthopaedics & Joint Replacement

Nov 08 , 2020 | 5 min read


Myth#1. “I should Wait As Long As Possible To Undergo Knee Replacement Surgery” 

Fact - Incorrect! It is not required to wait for the surgery until the pain becomes intolerable. However, longer life of joint replacements enables people to consider surgery even at a younger age (if required). Osteoarthritis is a degenerative disease that continues to damage the joint surface and deform the shape of bones around the knees. Unnecessarily waiting for surgery and delaying it, is technically more challenging for the surgeon and it causes patients’ health to deteriorate overtime and increases the likelihood of surgery related complications.

Myth#2“I Should Continue With Medications As Long As Possible And Avoid knee Replacement Surgery.”

Fact - Medicines including painkillers just give symptomatic relief for a temporary duration and prolonged usage is riddled with serious side effects such as renal failure, peptic ulceration etc. People with advanced arthritis definitely require surgery and cannot be cured by medicines. Several rheumatoid patients require knee replacement at a relatively younger age. Mending a severely damaged knee may reduce the longevity of the replaced joint because of technical complications.

Myth#3. Alternative Therapies Such As Acupressure, Ozone Treatment, Massage Beds, Oils, Laser Therapy, Magnetic Therapy; Braces Will Cure My Advanced Arthritis And Knee Pain.

Fact -  There is no scientifically proven permanent non surgical cure for advanced knee arthritis till date and these alternate therapies are not backed by established scientific data. All these modalities may provide temporary relief in early to moderate arthritis for some duration but they are not curative. It has been observed that may people end up trying these therapies as they are fearful of the uncertainty of surgery. Hence, trying these modalities may obviously delay the surgery for some time, but cannot avoid it.  

Myth#4. "I'm Too Old For Surgery"

Fact - Age is not a contradiction for surgery. If clinically fit, elderly patients regularly can also get total knee replacement surgery done. We have patients who have undergone knee replacement even at the age of 87 years and are enjoying life after knee replacement surgery.

Myth#5. Knee Replacement Is A Very Painful Surgery. There Is A Lot Of Pain In Post Operative Period.

Fact - Modern day pain management, such as in a multimodal approach, ensures that the patient does not feel any pain during surgery or in post operative period and has a smooth recovery.

Myth#6. After Knee Replacement, I’ll Have To Give Up Some Activities And Sports.

Fact - You have a high probability of getting back to activities like brisk walking or cycling in 6 to 12 weeks., however, it is better to avoid contact games. Squatting and sitting cross legged is possible but should be kept to minimal in order to have a longer life of the implant.

Myth#7Driving Is Not Possible After Knee Replacement.

Fact - This again is a complete myth. Driving is a lot easier after knee replacement. Most patients start driving within 6-8 weeks of surgery.

Myth#8. After A knee Replacement, It Takes Months To Recover.

Fact - After 24-48 hours of surgery, patients become independent for toilet activities. Weight bearing is tolerated and knee bending is permitted by this time. At around 3 weeks patients can participate in outdoor social activities. Ladies can enter kitchen and start making food as early as 4 weeks from the surgery. Majority of patients can resume their Job at 6 weeks.

Myth#9. Knee Replacement Is Done "One At A Time".

Fact - If the patient does not have significant co-morbidities and is deemed fit to undergo the procedure; then both knees can be replaced in the same sitting. In fact majority of our patients undergo both knee replacements at the same time.

Myth#10The New Knee Lasts For 10 yrs. Only.

Fact - With modern day precision including computer assisted knee replacement and advancement in biomaterials, the survivorship has increased considerably. Today's joint replacements last 20- 25 years or longer and, for many people, will last a lifetime.

Myth#11 “I Am Obese, I Cannot Undergo Knee Replacement Surgery.”

Fact - Knee replacement can be successfully done in an obese patient as well. Literatures show comparable results when compared to average weight people, although requires more expertise and some special techniques during surgery. Sometimes patients keep on waiting in the hope of reducing weight before the surgery is done. In fact with painful arthritic joint, it is very difficult to lose weight as the patient is less mobile. On the contrary, many of our patients actually lost weight after surgery as they were able to participate in brisk walking and exercise program after knee replacement.

Myth#12. “I Have Diabetes Or Hypertension Or Heart Ailment, So I cannot Undergo knee Replacement Surgery.”

Fact Dr. Anil Arora says, Diabetic, Hypertension and Heart ailments are no longer a bar for surgery. Detailed pre-an aesthetic checkup is routine now a days for every patient undergoing replacement surgery. To assess cardiac function of patient, several tests (Echo-cardiography, Dobutamina stress echo-cardiography, Thallium stress echo-cardiography etc.) are done prior to surgery. Treated patients of heart disease (with stenting or bypass graft) are better candidates for surgery then untreated heart patients. Though these diseases do not affect the outcome of surgery despite that caution is required. In fact one can gain better health and better control of Diabetes, Hypertension or Heart disease after knee replacement as one is able to walk without pain, and can go for long walks if required.

Myth#13. Knee Replacement Is Just Like Replacement Of Kidney Or Liver. My Whole Knee Will Be Removed And New Knee Put.

Fact - Not true at all. The whole knee is never replaced. Only worn-out articular surfaces of bones (usually 8-9 mm) are removed and replaced with artificial ones (implant). So, technically it is more of a "RESURFACING" or "REPAIR" rather than a "REPLACEMENT".

Myth#14. “I Can Choose My Implant By Searching Google.”

Fact - There are various designs of implants available with good long term results. Different surgeons are comfortable with different implant designs and instrumentation.  So, it is better to choose a surgeon & leave it upon him to choose implant for you.

Myth#15. Expensive Implants are Always Better!

Fact - Not always true. The standard implants with a track record of more than 10 years are costly as compared to some specific newer knees (Gold Knees). However, new implants are being sold to patients with a promise that they are of higher quality, but there is reliable data to support that they are indeed superior when implanted in a human body.  

Myth#16"I Can Always Get Good Results Getting A Costly Knee Implanted."

Fact - Not true. Results of surgery depend on the implant as well as its technique.

Myth#17. Computer Navigation Is Of No Use.

Fact - It is generally agreed that computer-navigated knee replacement gives a marginally better overall alignment.

Myth#18. Knee Replacement Cannot Be Done A Second Time.

Fact - In an unfortunate event, Knee replacement can be done again. It is is called as a revision joint replacement surgery with good survivorship.