How Long Can You Postpone or Put Off Total Knee Replacement Surgery? What are the Risks? When is the right time?
How long can I put off or delay knee surgery is one of the more common questions that patients ask when they are faced with reality that their knees are failing them.
When a surgeon explains that you have osteoarthritis in the knees, and the best way to treat the ailment is to have total knee replacement surgery, a patient’s first reaction is usually of despair.
A lot of times patients see it coming and are educated on the matter, but was hoping there was a mistake or perhaps a quick fix. Others are shocked or simply scared of the unknown.
Whatever category a patient falls into, when they find out for the first time they need total knee arthroplasty surgery, patients usually try to postpone the procedure.
Knee surgery is nothing to scoff at. The mental and physical preparation involved can be too much to bear for some.
So when is the right time to have total knee replacement surgery? How long can it be postponed? Unfortunately, there isn’t a definitive answer. However, some factors can be taken into consideration to give patients an idea.
When a patient starts to experience pain, they usually take OTC’s to help reduce the knee pain. Then it continues and gets worse. The pain eventually becomes too unbearable to walk across the room, let alone completing routine tasks, such as going to the grocery store or even using the bathroom.
Afterwards, patients visit a doctor and then a specialist. This is where they are informed that their cartilage has worn down. That essentially bone is rubbing against bone and the arthritis in the knee will only get worse as time progresses.
It’s natural to be concerned about such a procedure. Being provided this information patients have a range of emotions from sheer dread to accepting the fate and simply wanting to get it over with.
Some patients feel they are too old for having knee replacement surgery. However, countless studies have shown that age is not a major factor to weigh if you're undecided about the procedure (source).
Are there Other Options Besides Knee Surgery?
Yes, there are other options besides knee surgery. If you are not suffering from any deformities or other serious health issues you have other options besides total knee replacement (source).
1. Losing Weight - Reducing your weight has many benefits. By losing weight you will be reducing the amount of stress put on the knee. Of course, your overall health will improve as well.
2. Muscle Strengthening – Improving the strength of the muscles around the knee, such as the thigh (quadriceps), gluteus, and hamstring muscles; give the knee added support. This relieves stress and pressure on the knee. Thus, reducing pain when moving around.
3. Injections - Some patients just want a quick fix. Although Dr. Rashid Ganji, lead orthopedic surgeon at Sina Hospital, doesn’t approve of this method for long term results, he does provide some patients with the injections in order to put off surgery for a certain amount of time. He stresses to patients that it is only temporary relief. The pain and swelling will reduce in a short period of time.
Consequently, these symptoms return anywhere from 6 to 12 weeks. This form of treatment is only used in the early stage of osteoarthritis. Dr. Ganji never injects patients that have clear bone to bone contact due to severe osteoarthritis that occur in the final stages.
4. Supplements – A lot of research has been conducted on various supplements such as chondroitin and glucosamine. Basically it comes down to the patient’s pain threshold and how they reach to the medicine. They can be a temporary remedy to knee arthritis for some. For other’s it has no effect.
What Happens if I Delay Knee Surgery?
Even after you have received a total knee replacement, you still have to lose weight and strengthen your leg muscles. They are essential for a successful surgery.
If you still decline to have total knee replacement surgery, some other more serious consequences can occur such as:
1. Weakened Muscles and Ligaments - We’ve all heard the idiom, ”Use it or lose it”. Never is this more true than in this instance. When you need assistance from a walker or cane to get around in order to reduce the pressure on your knees, you're not giving your muscles a chance to work. Therefore, they grow weaker, as well as the surrounding knee ligaments.
2. Knee Deformities – Wind-blown knees, knock-knees or bow-legged deformities don’t happen in a day. They take years to form. However, it makes all aspects of the surgery more complicated for the surgeon and patient.
3. Inability to Perform Routine Activities - No matter your age, you need to be mobile. Serious pain will make a person think twice about doing simple tasks such as drinking water, let alone cooking, grocery shopping or leisure activities.
Final Thoughts on Postponing Total Knee Replacement
All that being explained, when you postpone surgery, you're making things worse. If a surgeon has said you need surgery, things will not magically get better overnight.
Many patients simply put up with the pain, hoping things will get better on their own. Unfortunately, later they learn that this is not the case. It only gets worse and complicates the TKR down the road.
It’s better to try other less invasive methods to remedy the pain as mentioned above. Of course, if the osteoarthritis has set in and is still advancing, the patient needs to make a decision. The dire consequences of putting of the surgery far outweigh any benefits you think there are.
At the end of the day, surgery is inevitable if a surgeon has explained you must do it. You really shouldn't delay the knee surgery much longer or it will only get worse.