Over the years, many patients have come to my office for a second opinion after another orthopedic surgeon has recommended total knee replacement for their arthritis symptoms. It’s my feeling that knee replacement is only necessary under very specific circumstances.
The Presence of Mechanical Symptoms
When a patient visits my office with the signs and symptoms of arthritis of the knee, one of the first questions I ask is, are they experiencing any mechanical symptoms like catching or locking of the knee joint? Mechanical symptoms could indicate the presence of another problem inside the joint, like ligament instability or a meniscus tear. Sometimes, X-rays may fail to show these concerns, even when the scans do clearly indicate the presence of degenerative arthritis.
Evaluating the severity of all the symptoms related to arthritis is part of determining whether surgery is necessary. When significant mechanical symptoms are present, there are two surgical treatment options: arthroscopic treatment and total knee replacement. Arthroscopic treatment may be sufficient to correct loose bodies within the joint or repair a meniscus tear, while I only perform knee replacement surgery when all other non-surgical approaches have failed to give the patient sufficient relief.
In my practice, my preference is for joint preservation and restoration whenever possible over joint replacement surgery. The body’s natural capacity for healing is impressive, and treatments such as stem cell therapy and PRP help promote healthy regrowth in worn cartilage that can render surgical knee replacement unnecessary. It’s only when the symptoms fail to respond to conservative treatments that I recommend proceeding with any type of surgery for arthritis of the knee.