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Who is a candidate for total knee replacement?

Unfortunately, there are not many options for patients who have such severe osteoarthritis of their knees that surgery is being considered. Many orthopedic surgeons will say that the decision to have a total knee replacement depends on the patient, in that, if the patient can no longer tolerate the pain and/or it has a major impact on his life, then a knee replacement should be considered. With that said, total knee replacements are shown to significantly reduce or even eliminate the pain associated with osteoarthritis of the knees.

Dr. Travis M. Hendry, MD
Orthopedic Surgeon

Total knee replacements are usually performed in people with painful arthritis that limits their ability to move around. Most patients are over 55 years old, but the operation may be considered for younger people as well. Your doctor may recommend total knee replacement if:

  • You have pain and stiffness in your knee every day
  • Your knee is so painful that you have trouble with daily activities such as climbing stairs, dressing, bathing or preparing meals
  • Your knee is unstable and "gives out"
  • You have a knee or leg deformity
  • Medications, weight loss or injections have been tried and are not helpful
Dr. Calin S. Moucha, MD
Orthopedic Surgeon

The decision to have total knee replacement surgery should be a cooperative one between you, your family, your primary care physician and your orthopaedic surgeon. Your physician may refer you to an orthopaedic surgeon for a thorough evaluation to determine if you might benefit from this surgery.

There are several reasons why your doctor may recommend knee replacement surgery. People who benefit from total knee replacement often have:

  • A knee that has become bowed as a result of severe arthritis.
  • Severe knee pain or stiffness that limits your everyday activities, including walking, climbing stairs and getting in and out of chairs. You may find it hard to walk more than a few blocks without significant pain and you may need to use a cane or walker
  • Moderate or severe knee pain while resting, either day or night
  • Chronic knee inflammation and swelling that does not improve with rest or medications
  • Knee deformity—a bowing in or out of your knee
  • Failure to substantially improve with other treatments such as anti-inflammatory medications, cortisone injections, lubricating injections, physical therapy or other surgeries

There are no absolute age or weight restrictions for total knee replacement surgery.

Recommendations for surgery are based on a patient's pain and disability, not age. Most patients who undergo total knee replacement are age 50 to 80, but orthopaedic surgeons evaluate patients individually. Total knee replacements have been performed successfully at all ages, from the young teenager with juvenile arthritis to the elderly patient with degenerative arthritis.

Ideal candidates for total knee replacement must have medical conditions under control and must have a body mass index (BMI) of less than 40 and a hemoglobin A1c under 8. Otherwise, candidates for total knee replacement include:

  • People with painful, severe bone-on-bone arthritis of the knee that is no longer controlled with non-surgical or conservative treatment options
  • People suffering from inflammatory arthritis of the knee, such as rheumatoid arthritis
  • People who have arthritis of the knee and the sensation of instability (feel the knee giving out)

Replacing the knee is necessary when pain becomes too intense and you've gone through other types of treatment.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.