Knee pain can be debilitating, hindering everyday routines from daily walks to basic needs like a good night’s sleep. When conservative treatments don’t seem to work, a knee replacement may be the optimal solution to restore mobility, relieve pain and regain control of one’s life. But how do you know if you’re a candidate? This article takes a look at the key conditions that call for knee replacement surgery, backed by data and expert recommendations.
Reach out to our specialists at Hip & Knee Orthopaedics for a more comprehensive evaluation and personalised treatment plan.
When Is Knee Replacement Recommended?
Knee replacement, also known as knee arthroplasty, is considered when chronic knee pain and stiffness significantly impair quality of life. According to LSI’s Global Procedure Volumes Database, about 3.6 million knee replacements were performed worldwide in 2023. In Singapore, demand for knee replacements is expected to grow, driven by an ageing population that’s not only more active, but also increasingly aware of available treatment options.
1. Severe Osteoarthritis (OA)
Osteoarthritis is the leading cause of knee replacements, accounting for 90% of all procedures. OA breaks down cartilage, resulting in bone-on-bone friction, inflammation and chronic pain.
When Surgery Might Be Recommended
- When pain persists despite medications, physical therapy and injections.
- When imaging such as X-rays and MRIs shows significant joint damage.
- When stiffness or deformity limits daily activities, like walking or climbing stairs.
A study published in the National Library of Medicine found that 90% of postoperative patients report reduced pain and an enhanced quality of life related to their health following surgery for osteoarthritis.
2. Rheumatoid Arthritis (RA) and Inflammatory Arthritis
Unlike OA, which is brought on by wear-and-tear, rheumatoid arthritis (RA) is an autoimmune disease that causes joint inflammation. When prolonged, RA can destroy cartilage and bone, leading to severe and irreversible deformity.
When Surgery Might Be Recommended
- If disease-modifying drugs (DMARDs) fail to control symptoms.
- When joint damage is visible on imaging.
- If pain interferes with basic tasks, like standing or dressing.
Total joint replacement surgery is now considered the most effective surgical option for treating severe joint damage and deformities in late-stage RA.
3. Post-Traumatic Arthritis
Injuries like fractures, ligament tears (ACL), or meniscus damage can accelerate arthritis progression. The New York Times states that the chance of developing arthritis within 10 years after tearing a tendon or ligament in the knee is over 50%.
When Surgery Might Be Recommended
- If previous trauma led to chronic instability or misalignment.
- Pain persists after physical therapy and bracing.
- Progression of post-traumatic arthritis causing pain and limitation of mobility
People who have experienced joint trauma are often diagnosed with knee osteoarthritis around 10 years earlier than those without any prior injury.
4. Severe Bowleg or Knock-Knee Deformity (Genu Varum/Valgum)
Abnormal knee alignment puts pressure on one side of the joint, speeding up cartilage wear. While bowlegs cause the legs to curve outwards, knock knees result in the knees angling inwards and touching each other.
When Surgery Might Be Recommended
- The deformity causes uneven weight distribution and pain.
- Conservative treatments (braces, orthotics) don’t help.
Bowlegs are usually not serious in children, but should be diagnosed and corrected before reaching adulthood. Many individuals with untreated bowlegs may eventually need a knee replacement, often at an earlier age than typical candidates for the procedure.
Who Makes a Good Candidate for Knee Replacement?
Not everyone with knee pain needs surgery. Suitable candidates usually meet these criteria:
- Chronic pain unresponsive to at least 6 months of conservative treatment.
- Significant mobility loss, such as being unable to walk more than a few blocks.
- X-ray/MRI-confirmed joint damage.
- Drop in quality of life as a result of knee pain.
Contrary to popular belief, age is less important than joint health. While most recipients are 60 – 80 years old, younger patients with severe arthritis may also benefit from knee replacement surgery.
When to Delay or Avoid Surgery
Nonetheless, knee replacement is a major surgery, so doctors may advise against it if:
- Infection is present, as it may present higher risk of implant-related infection
- There are existing health conditions, such as those of the heart and lungs, that can increase surgical risks.
Most patients with chronic conditions can undergo knee replacement surgery. A good discussion with the surgeon is necessary to understand if you are a suitable candidate for the procedure.
Is Knee Replacement the Right Choice for You?
If knee pain is observed to restrict your life and other treatments haven’t helped, a replacement could be life-changing. Advances in surgical techniques and implants mean 90% of knee replacements last 15 – 20 years.
Seek Individualised Care, Support and Relief at Hip & Knee Orthopaedics
Contemplating a knee replacement for yourself or a loved one? It would be beneficial to consult with an orthopaedic specialist to explore your options.
Taking action early can help prevent further damage and lead to better long-term outcomes, specifically in the next 10 – 15 years. At Hip & Knee Orthopaedics in Singapore, we’re led by two experienced orthopaedic surgeons who specialise in hip and knee surgery and replacement. Get in touch with us for personalised care, starting with an initial consultation to thoroughly assess your current knee condition. Don’t delay—early intervention can make all the difference in preserving your mobility and quality of life.
Explore our blog for more information and resources on hip and knee conditions, as well as prevention and management strategies.
