Knee Replacement: Is It Time to Go Under the Knife?

Knee Replacement Should You Go Under the Knife

Knee replacements among people over the age of 65 are on the rise. Here’s what to consider before you decide whether to have one.

Knees creak and groan every time you get up from your chair? A knee replacement may be in your future. About 800,000 knee replacements are done in the United States every year. By 2030, that number is expected to rise to 3.5 million!

More than 90% of people who have a knee replacement experience a dramatic reduction in knee pain. But, like any surgery, a total knee replacement carries risks. It also isn’t a magic bullet. “We can’t take someone who is doing awful and suddenly make them perfect,” David Jevsevar, MD, chair of the department of orthopedics at the Geisel School of Medicine at Dartmouth, told Consumer Reports.

Here’s some things to think about to figure out if a knee replacement surgery is right for you.

Why people need knee replacement surgery

The main reason people aged 65 and older require knee replacement surgery is osteoarthritis. This is arthritis caused by age-related wear and tear. The cartilage that cushions your knee bones wears away with time. Your bones then rub against each other, which can really hurt. It’s a normal part of aging, but boy, can it be painful.

If you had a serious knee injury in the past—say, you busted your knee in a car crash—then you can develop knee osteoarthritis earlier in life. It may also be more severe.

A knee replacement may sound great, but there are some lifestyle and treatment approaches that your doctor will want you to try first. These include:

Weight loss

Your knee experiences about four pounds of pressure for each pound of body weight. Even a small amount of weight loss—just 10 to 15 pounds—can really help to reduce pain.

Learn about Medicare coverage for bariatric weight loss surgery.

Exercise and physical therapy

It hurts to move, but if you strengthen the muscles around your knee, you’ll take pressure off it. Simple motion like walking can also be therapeutic – the more you move your knee, the less likely it is to stiffen up on you.

Medications

Over-the-counter pain relievers like acetaminophen (Tylenol), ibuprofen (Advil), or naproxen (Aleve) can help. Just talk to your doctor before you use them. People with heart, kidney, or liver disease need to be particularly careful using pain relievers.

Knee braces

A knee brace can help relieve pain by reducing pressure on the affected part of your knee. Braces can be custom made by an orthotist or purchased off the shelf.

Injections

Your doctor may suggest an injection of cortisone, which relieves swelling, or hyaluronic acid, which can increase joint lubrication. Doctors usually limit the number of times you can get these injections in your knee, and they don’t work for everyone.

If you’ve tried all of these steps and you’re still miserable, it’s time to consider a knee replacement. Generally, it’s recommended if it’s hard to even do simple activities like walking or climbing stairs. You may also even experience pain if you’re sitting or lying down.

Not your father’s knee replacement

Knee replacement surgery has come a long way in recent years. Surgery breakthroughs mean there’s less pain, faster recovery, and a lot less time in the hospital. You may not even need to stay overnight!

What’s more, about 90% of all knee replacements last for about twenty years. If you’re over the age of 70, you have less than a 5% chance of needing revision surgery. Even people over age 80 are getting knee replacements – and reporting the same level of satisfaction with them as younger people do.

Next steps

If you do want knee replacement surgery, see at least two orthopedic surgeons so that you can get a second opinion.  Your x-ray may show that there’s a lot of damage to your knees, but if you can walk and do all the activities you enjoy, the surgeon may recommend that you wait a few more years.

Choose an experienced surgeon. Ask your surgeon how many knee replacement surgeries they do every year. Ideally, they should do at least fifty, and the medical center where you get the surgery should do hundreds if not thousands.

Even with an excellent surgeon, complications can happen. Although it’s rare, you need to be aware of possible risks like infection, blood clots, and nerve damage. You can do your part in reducing your risks by losing weight and quitting smoking before your surgery.

Learn 9 Tips to Quit Smoking (And How Medicare Can Help)

Finally, be realistic with your expectations. If you’ve never run more than a mile in your life, don’t expect that you can start after a knee replacement. Many doctors advise against high impact activities like jogging, jumping, or CrossFit classes if you’ve had a knee replacement. But surgery may enable you to do plenty of things you love, like walk, swim, play golf or pickleball, go for hikes or bike rides with your grandkids, and even take up ballroom dancing!

Is my knee-replacement surgery covered by Medicare?

Medicare will cover your knee replacement surgery if your doctor says it’s medically necessary, including rehabilitation at a short-term skilled nursing facility if you meet certain criteria. Physical therapy and medical equipment like a walker are also covered. (For more details, check out our blog post Does Medicare Cover Knee Replacement.)

You may well have even broader coverage under a Medicare Advantage plan. Meal delivery services, at-home nursing visits, and rides to medical appointments are some of the benefits most Advantage plans offer. Find out more about the Medicare plan options in your area with our easy-to-use Find a Plan tool.

Additional resources

ANGELA ESCOBAR
Angela Escobar writes about lifestyle, health, and wellness for the 50+ crowd. Based in Arizona, when she isn't writing and editing, she likes to spend time with her husband, their dogs, and brag about her two adult children.

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