Doctor's Answers (1)
Osteoarthritis means the “normal” wear and tear of the joints, and the accompanied inflammation (“itis” means inflammation in Latin, typically presented as pain and swelling).
It comes with aging, but of course, to varying degrees and different severity.
Osteoarthritis itself is not a dangerous disease that will threaten your life or safety per se, so not everybody suffering from osteoarthritis needs to go under the knife to have surgeries.
However, when the arthritis is so severe that it causes significant functional limitation in your daily activities and your quality of life, you should consider treatment.
Mild arthritis can be well controlled with medication/ lubricant injections.
Severe arthritis, defined as complete loss of cartilage and significant mal-alignment of the limb, usually can only be cured by surgery.
I always tell my patients that “humans are like cars, and our knees are like the car tyres”. Your description of “bone on bone” appearance actually refers to the complete loss of cartilage in your knees.
If you imagine yourself like a car, the rubber tyres have been completely worn out and the metal rims are directly grinding on the ground!
I think few people would wait for another 3 years to change the tyres, so why would you wait another 3 years to replace your knees?
Gone are the days when the success rate was 50/50 or the implants can only last 5-10 years.
With modern technology, we are pushing the success rate of knee replacement surgeries to >95% and the implant longevity to 15-20 years (with the advanced ceramic OXINIUM™ implants).
So coming back to your question about “How do I know if I need to get a total knee replacement”, I would actually say that the patient would know the best.
If your knees pain are persistent and prevent you from doing your daily activities and affecting your quality of life, then you should at least see an orthopaedic surgeon and do an X rays/ MRI scan to determine the severity of your knee arthritis.
As I have mentioned earlier, mild to moderate arthritis can usually be well controlled with medication/ lubricant injections), while severe arthritis with complete loss of cartilage (“bone on bone” apperance as described) can only be cured with knee replacement surgeries.
The other benefits of treating the knee osteoarthritis early is to protect the other joints. As I have said, human are like cars.
If one tyre is down, the remaining 3 tyres will have to take on the extra load, so the next thing you know is that your other knee will start to ache because of the extra load to bear, and your spine will start to have pain because of the poor walking posture due to the significantly bowed knee.
And not forgetting that all the strong pain killers have significant side effects to the stomach, kidneys, heart if consumed for prolonged perior of time. Personally I have seen patients suffering from gastric ulcers/ kidney failure simply by taking these strong pain killers everyday!
Your knees can be replaced easily, with the success rate well > 97%, but your stomach/ kidneys cannot be replaced!