If you’re dealing with significant knee discomfort and conservative techniques have failed to help you find relief, the next logical step in the process is joint replacement surgery. Recently, the American College of Rheumatology (ACR) and the American Association of Hip and Knee Surgeons (AAHKS) decided to examine whether or not there was any merit to putting off knee replacement surgery after conservative techniques had failed, or if waiting only harmed the patient.
In the vast majority of instances, they found that patients were better off not waiting to pursue knee replacement surgery, but there was at least one instance where patients were told not to jump into joint replacement surgery just yet. We explore those new recommendations and explain why your surgeon may have you hold off on surgery for a little bit in today’s blog.
Don’t Put Off Knee Replacement Surgery
In an effort to provide patients with the best recommendations, the ACR and AAHKS reviewed current practices and documented outcomes for patients who had significant knee osteonecrosis and had not seen symptom or function improvement with normal conservative techniques, like physical therapy or weight loss. In this group of patients, they found that patients were much better off pursuing knee replacement surgery sooner rather than later. If patients put off surgery for longer, it typically only led to worse degeneration in their knee prior to surgery, and that’s not ideal. Even though your knee isn’t in the best shape, you want it to be as healthy as possible prior to surgery, because that will make it easier for you to experience the fullest recovery after surgery.
According to the review and the updated guideline, there is no clear benefit to any of the following treatments being pursued in place of joint replacement if non-operative treatments have already failed:
- Physical Therapy
- Gait Aids
- Oral Anti-Inflammatories
- Injections
Now, that’s not to say that any of the above treatments should not be pursued in the lead up to your operation. As we already mentioned above, you want your knee to be as healthy as possible heading into surgery, and one way to do that is with a healthy dose of prehab, and that oftentimes involves physical therapy, gait training and weight loss, among other things.
When To Put Off Surgery?
However, there were two key instances where doctors recommended that patients focus on other aspects of their health before scheduling their knee replacement operation. The recommendation states that individuals with nicotine dependence and diabetics should consider putting off surgery until they can either cut back or eliminate their nicotine dependance, or until they achieve better glycemic control.
A number of different surgical risks and complications increase if a patient is a heavy smoker or a diabetic with poor blood sugar control, so if you can give up smoking or better manage your diet and your blood sugar levels, you may be able to significantly increase your likelihood of a successful surgery without complications.
Surgery will still be in your future, but all factors need to be considered prior to surgery, and that’s why diabetics and smokers may be told to review these aspects of their health before the doctor will set them up on the operation schedule. If you need help managing any of these aspects of your health, or you just want to talk to a specialist about any knee or hip discomfort that you’re experiencing, reach out to Dr. Botero and his team today at (865) 558-4444.
