Mature matters: Knee pain
What lies beneath: image shows x-ray of knee replacement
I am 68-years-old and have had knee pain for the last 15 years.
It keeps getting worse and lately it has begun to really impinge on my daily life. Do you think getting a knee replacement is a good idea? What are the risks of the surgery? Am I too old?
A Firstly, you are never too old for surgery. Outcomes in surgery depend less on age itself and more on whether you have illnesses such as heart failure, angina, chronic bronchitis or excess weight.
The most common cause for knee replacement surgery is osteoarthritis which sounds like the condition you are suffering from. No surgery is without risk, however, so more conservative measures are preferred initially.
For example, following knee replacement surgery up to one in 10 will develop a clot in the leg, one in 50 may develop an infection in the joint and one in eight may have persistent pain even after the operation.
In those with mild or even moderate arthritis regular pain medication and exercise are genuinely effective. When taken regularly (and it usually isn't) paracetamol or Solpadiene can really take the edge off the pain, especially when this allows the person to become more active.
Increasing your activity builds up the muscles around the knee which stabilises it and lessens the pain further.
People incorrectly think of activity as gym work. In fact, the recommended activity for people with osteoarthritis is walking, cycling, gardening or swimming. It is a challenge trying to find the best type of fun and sustainable physical activity, yet not place excessive strain on your joints, so shop around and find one that suits you.
If you haven't previously committed to these measures in a sustained way then it's never too late for a new year's resolution.
Certainly if those measures have been unsuccessful and you have severe osteoarthritis then a knee replacement is worth considering.
We define severe osteoarthritis as meaning that you are unable to do basic daily activities as a result of knee pain or that you are unable to sleep from the pain.
It sounds like you may be approaching this category but I certainly wouldn't even consider surgery until I had exhausted all the above options first.
Despite the risks involved, if you meet the criteria I have mentioned, a knee operation can offer you a new lease of life. It is successful in alleviating pain in the majority of people who go ahead with it.
In 90pc of patients the new knee will hold up for up to 15 years which is quite good when you compare its lifespan with most other mechanical devices these days!
So, first of all, give simple analgesia and regular physical activity a really good go. If this still doesn't help talk to your doctor about possible knee-replacement surgery and discuss your individual risks with her or him.
Dr Dan Ryan, specialist registrar in strokes and geriatric medicine,
Mercer's Institute for Research on Ageing, St James's Hospital, Dublin 8
ageing@independent.ie
- Dr Dan Ryan
Originally published in
