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Common Conditions for Knee Replacement Candidacy

Healthy knees are vital for many people to complete every day, physical activities.

Unfortunately, when the knee joint is painful and stiff, even simple acts such as rising from bed, climbing stairs, or bending down to pick up objects can seem nearly impossible. Moreover, your condition can inhibit your ability to work, hinder your social life, and prevent you from participating in sports and exercise. When knee pain and stiffness become so severe that it interferes with your ability to live a normal life, and less invasive treatment options have failed, an orthopaedic specialist may recommend knee replacement surgery.

Knee replacement surgery, or knee arthroplasty, is a safe and effective treatment for relieving your knee pain, restoring your mobility, and improving your overall quality of life. In fact, knee replacement is considered a routine procedure with approximately 600,000 surgeries performed in the United States each year. At Beacon Orthopaedics and Sports Medicine, we routinely treat a diverse range of patients—including patients between 50 and 80 years of age to younger high school and college athletes—for knee pain and stiffness.

And while the patients we treat vary in age and activity level, they commonly have one of the following conditions:

  • Osteoarthritis
  • Rheumatoid arthritis
  • Hemophilia
  • Avascular Necrosis

These conditions often cause intense pain and loss of mobility that require surgery. Continue reading for information about each of the conditions that commonly require knee replacement surgery.

Osteoarthritis

Osteoarthritis, also known as degenerative arthritis or “wear and tear” arthritis, is the most common reason for knee replacement surgery. Osteoarthritis is a degenerative condition in which the cartilage covering the ends of the bones gradually wears away. And while osteoarthritis has historically been thought to be caused by the natural wearing away of cartilage over the years, it is now treated as an active disease that affects every component of a joint.

Post-traumatic arthritis is a specific form of osteoarthritis that results from a direct injury to a joint such as a break or dislocation. Athletes who participate in sports that cause direct blunt trauma to joints (such as football, soccer, or lacrosse) are at higher risk of developing post-traumatic arthritis. With that said, it’s important to note that even non-athletes are at risk. A vehicle accident or even just a significant fall can cause enough physical trauma to a joint that can lead to post-traumatic arthritis.

Osteoarthritis has no directly identifiable cause but, like other forms of arthritis, it tends to run in families and is believed to have a genetic basis. It usually occurs in individuals 50 years of age or older, but it may also occur in younger individuals.

Signs and Symptoms

Pain and stiffness are the most common symptoms of osteoarthritis. Pain will typically occur during activity and after movement. By contrast, stiffness will be most noticeable after waking up or after a period of inactivity. These symptoms tend to develop over time rather than come on suddenly. Some other symptoms of osteoarthritis in the knee include:

  • Swelling around the knee joint
  • Limited range of motion in the knee
  • Tenderness when pressure is applied to the joint
  • Clicking or cracking sound when the knee bends
  • Deformity, bone spurs, or lumps in the knee

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic inflammatory disorder in which the body’s own immune system mistakenly attacks the joints. As a result, the tissue that lines the inside of joints thickens and causes painful swelling. If inflammation continues, it will permanently damage bones, cartilage, and ligaments, eventually causing the joint to become loose, painful, and difficult to move.

Signs and Symptoms

Similar to osteoarthritis, pain and stiffness are also common symptoms of rheumatoid arthritis. Some other symptoms of rheumatoid arthritis in the knee include:

  • Swelling and redness around the knee joint
  • Limited range of motion in the joint
  • Tenderness around the knee joint
  • Joint warmth, with or without visible swelling or redness
  • Fatigue, particularly when the knee is inflamed

Hemophilia

Hemophilia is a rare disorder in which blood doesn’t clot normally. An individual with hemophilia may bleed longer due to their blood clotting more slowly. In mild instances of the disorder, its signs and symptoms may not be readily apparent. However, in severe instances, the individual may bleed for a significant length of time following an injury or even bleed without an apparent cause.

Individuals with hemophilia are at high risk of hermathrosis, or bleeding within joints. Over time, recurrent hermathrosis causes cartilage to erode away and joints to become destroyed. Eventually, the now unprotected ends of bones begin to rub together causing intense pain and damage with movement. Bending the knee also becomes difficult due to the build-up of scar tissue. By age 20 to 30, the majority of people with hemophilia will suffer from some degree of joint damage and stiffness. In short, the results of hermathrosis are primarily why knee replacement surgery is one of the most common procedures performed on patients with hemophilia.

Signs and Symptoms

The primary sign and symptoms of hemophilia are excessive bleeding and easy bruising.

External signs include:

  • Prolonged bleeding
  • Heavy bleeding from a minor cut
  • Bleeding from a cut that resumes after stopping for a short time
  • Bleeding that occurs without an apparent cause
  • Deep bruises
  • Bruises that occur without an apparent cause

Internal signs include:

  • Bubbling or tingling sensation within the joint
  • Joint warmth, with or without visible swelling or redness
  • Limited range of motion in the joint

Avascular Necrosis

Bone consists of living tissue that requires a constant supply of nutrients delivered to it by blood. Without blood, the bone tissue will eventually die and the bone collapses.

Avascular necrosis, also called osteonecrosis, is the death of bone tissue due to a lack of blood supply. Reduced blood flow can be caused by an acute traumatic injury, such as a dislocation or fracture, that damages blood vessels. Fat deposits in blood vessels, as well as certain diseases, can also block the flow of blood to bones.

While avascular necrosis can occur in anyone, it is most common in people age 30 to 50. It often begins as a painless bone abnormality and can remain painless while the condition advances. Unfortunately, the condition advances quickly and the damage it causes is irreversible. This means that early detection is critical in order to preserve your knee joint and other bone structures in your body. Eventually, the damaged bone will become painful to use. The outcomes of nonoperative treatment of osteonecrosis are relatively poor and most patients require replacement surgery.

Speak with an Orthopaedic Specialist

If you have any of the aforementioned conditions as well as severe knee pain that limits your activities during the day and interferes with your sleep at night, you should speak with an orthopaedic specialist.

At Beacon Orthopaedics and Sports Medicine, Dr. Haleem Chaudhary can talk to you about the differences between a partial knee replacement and total knee replacement, assess your personal health history and factors, and determine if you need a knee replacement.

Learn more about Dr. Chaudhary or schedule an appointment. For your convenience, he is available at Beacon East, Summit Woods, and Beacon West in Ohio or at Beacon’s Northern Kentucky location. You can also ask if you’re qualified for Dr. Chaudhary’s new study that utilizes Zimmer Biomet and Apple Watches to guide patients through the surgery and rehab process, and improve it.