What is osteoarthritis?
Osteoarthritis commonly affects the weight bearing joints of the ankle, knees, hips, pelvis and spine however, can also be developed in the shoulders, elbows, wrist and thumbs. A healthy joint is made up of two bones which serve to move on each other. Covering the ends of each bone is a shiny smooth coating of cartilage which in part allows the joint to slide, glide and rotate providing functional movement. The cartilage within each joint is bathed in synovial fluid which maintains good cartilage health and shock absorption.
When we use our weight bearing joints and increase their mileage the cartilage may become worn like the tread on a tyre. Our bodies attempt to repair the cartilage however are unable to replace cartilage tissue like-for-like with the shiny smooth cartilage slowly being replaced with rough bone. The change in joint structure causes symptoms of stiffness, swelling and pain.
Why am I being advised to wait for a total knee replacement?
Total or partial knee replacements are a very common safe treatment for worn out knees caused by end-stage Osteoarthritis. You are likely to be considered suitable for a knee replacement from the National Health Service if your knee is having a considerable impact on your quality of life and all other conservative treatments options have been explored.
It is not uncommon for younger people to have pain and disability from osteoarthritis. Without knowing how long a knee replacement lasts younger people are generally advised to put replacement surgery on the back burner for as long as possible.
The procedure to replace a knee involves removing part of the bone in order to fit the prosthesis. You can only have this procedure performed if you have enough good quality bone to attach the prosthesis to. A concern of the medical profession is a younger more active population may wear out a replacement joint too quickly requiring one, two or three revisions of the prosthesis which may be detrimental to their long term health and physical function. Patients would obviously like a pain free joint and be able to engage fully in their life right now.
How long do knee replacements last?
In a recent review of published research with more than 15 years follow up the paper concluded that –
- There is a 15 year survival rate of 96.3% for total knee replacement
- There is a 20 year survival rate of 94.8% for total knee replacement
- Half knee replacements (unicondylar knee replacement) are preformed much less with poorer outcomes.
However, ultimately it is still unknown how long knee replacements will last. This latest paper can help make informed decisions about best care and provide patients with further education to help inform and manage their condition.
Conservative treatment options
What we do know is that we can provide symptom relief from osteoarthritis. Evidence suggests that education, exercises and pain medication can improve function and reduce pain.
What we can offer you at Fay Pedler Physiotherapy
- Lifestyle advice
- Physical activity recommendations
- Tailored exercise programmes for stretching, strengthening and range of movement
- Alternative pain relief such as acupuncture, TENS and steroid injections
- Advice on footwear and supports
- Help you understand treatment pathways
- Education such a pacing, nutrition and supplement advice
- Walking aids