What would make a patient over age 75 a good candidate for knee replacement surgery?
As Dr Henry mentions, age is but a number and should not impact on whether you are suitable for an operation. Nevertheless, your other medical conditions may play a part in terms of anaesthetic risk and post-operative recovery. If you have exhausted all avenues of treatment for your knee, then it is definitely worth considering surgery.
However, if your pain is mild and does not significantly impact on your function, then its worth considering other options such as viscosupplementation, physiotherapy and weight loss. Some people are now having PRP injections for knee osteoarthritis - while the evidence is debated, it is still something to consider.
Age is just a number, if you have been taking care of yourself well. Even if you have a disease such as diabetes/high blood pressure/ high cholesterol, as long as they are well under control, the risk of any major life-threatening event happening in the surgery is actually less than 1%.
I have seen many patients who are barely 40+ years old, but they never quite take care of themselves and control their disease, and consequently, they suffered from various severe illnesses like kidney failures, strokes and heart attacks. And personally, I’ve taken care of a patient who is not even 40 years old, but she had already lost 3 limbs (both legs and right hand) due to poorly controlled diabetes.
This is the concept of physiological age - your body can be kept at an optimal condition if you take care of it well. The physiological age of your body could be at about 40-50 years old even when your chronological age is already 70s! Vice versa, I have seen patients who are at their 70s running a marathon and even doing Taekwondo!
And if you have been taking care of yourself well, it is very likely that you will live longer than average (the average lifespan of a Singaporean Woman is 86 years old according to the Census 2010), hence It means that you will need to suffer from knee pain for another 10 – 20 years. It is certainly not fun having to deal with pain for the rest of your life.
Knee replacement surgery is the most reliable treatment option for end-stage knee arthritis in the elderly population, with the success rate exceeding 95% in experienced hands.
It effectively removes the pain, and restores the quality of life.
I’ve always used this analogy when I’m counselling my patients – “humans are just like cars, the knee joints are like the tyres. If your car engine and everything else is still fine, what would you do when the car tyres are worn out?”
I’m sure everyone would choose to replace the tyres, rather than writing off the car.
Hence, if you have been taking care of herself well (the car engine is still strong), I hope you won’t write off your own car (or your “Kah” in Hokkien) when your tyres (knee joints) get worn out.
A new set of tyres (knee replacements) will definitely bring a new lease of life.
Of course, doctors will still need to a thorough full body check up before proceeding with surgery to ensure your fitness.
I hope I answered some of your queries.
Dr. Henry Chan
Consultant Orthopaedic Surgeon
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