DO YOU RE­ALLY NEED A NEW KNEE?

Men's Health (Singapore) - - HEALTH - — Laura Beil

A RE­CENT STUDY

found that a third of the more than 600,000 knee re­place­ments done an­nu­ally in the U. S. may not be nec­es­sary. Other re­search finds that more than 10 per­cent of pa­tients aren’t sat­is­fied with the re­sults. “You need to have moder­ately ad­vanced arthri­tis and to have failed con­ser­va­tive care for to­tal knee re­place­ment to be ap­pro­pri­ate,” says or­thopaedic sur­geon Ni­cholas DiNu­bile, M.D. Be­fore go­ing un­der the knife (and ham­mer and drill), ask your­self these five ques­tions:

1 HOW BAD IS IT?

Peo­ple who are dis­sat­is­fied af­ter surgery tend to have had only mild or mod­er­ate pain, or no se­vere lim­i­ta­tions on func­tion, be­fore­hand. Your sur­geon should be able to see X-ray ev­i­dence of nar­rowed space in the joint or bo­neon-bone.

2 HOW STRONG ARE MY QUADS?

Thigh mus­cles move and sta­bi­lize the joint, so the stronger they are, the more sat­is­fied you’ll likely be af­ter surgery, re­ports a study pub­lished in the Jour­nal of Or­thopaedic Sci­ence.

3 HOW DO I DEAL WITH PAIN?

Peo­ple who fix­ate on pain or feel help­less in the face of it can have trou­ble cop­ing with post-op dis­com­fort and tend to be less sat­is­fied with the re­sults. If you are tak­ing nar­cotics or opi­oids, Dr. DiNu­bile strongly ad­vises mak­ing ev­ery ef­fort to get off them be­fore surgery. You’ll have bet­ter pain re­lief af­ter surgery and a bet­ter sur­gi­cal out­come, he says.

4 AM I PRE­PARED TO DO THIS AGAIN SOME­DAY?

Pros­thetic ma­te­ri­als like ti­ta­nium and cobalt-chromium al­loy still don’t have the longevity of nat­u­ral bone and soft tis­sue, so switch­ing out knees in your 50s and early 60s may mean need­ing a re­peat pro­ce­dure in about 20 years. That’s es­pe­cially true for men, whose re­vi­sion rates are sig­nif­i­cantly higher than those of women— pos­si­bly be­cause we tend to re­sume stren­u­ous ac­tiv­i­ties that in­jured us orig­i­nally.

5 HAVE I TRIED EV­ERY­THING ELSE?

Don’t think of knee re­place­ment as a quick fix. De­spite its pop­u­lar­ity, keep in mind that it’s still a ma­jor op­er­a­tion with po­ten­tial risks and ex­ten­sive re­hab.

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