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Tag: Knee replacement

  • Think twice before getting a knee replacement

    Think twice before getting a knee replacement

    Liz Szabo reports for Kaiser Health News about the high proportion of people who get knee replacements and wonder whether they should have. For about one third of people, knee replacements do not ease arthritis pain. Better treatments include pain relievers, diet changes, and physical therapy.

    Knee replacements are fairly common procedures, considered safe and effective. More than 750,000 people receive them each year. But, in some cases, they may cause more harm than good. Doctors and hospitals make money from knee replacements and may not warn you about their risks.

    People get knee replacements to address chronic pain, But, a knee replacement is not always a cure for pain. Indeed, it can bring on more knee pain, which can spread to your hips and back.

    Knee replacement surgery has serious risks. The data suggests that as many as one in three people suffer chronic pain as a result of a knee replacement. About twenty percent of people who have the procedure are unhappy with the result.

    People who get knee replacements are far more likely to develop complications than people who use non-surgical treatments such as pain relievers and physical therapy to relieve their pain. Infections, blood clots and knee stiffness are all too common side effects of surgery and may lead to the need for another medical procedure. Between one and two percent of people who get knee replacements die within three months.

    You may not want to get a knee replacement if  you have mild arthritis. A BMJ study found that quality of life does not tend to improve for people with mild arthritis.

    And, you probably do not want to get a knee replacement in order to be able to engage in heavy duty sports, such as basketball. Artificial knees tend not to be meant for heavy duty exercise.

    Finally, if you are relatively young and believe you would benefit from a knee replacement, keep in mind that artificial knees only last about 20 years before they must be replaced. They can wear out and leave particles that inflame the knee area. They also can loosen and separate from the bone. If you need to replace an artificial knee, the risk of complications is higher.

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  • Physical Therapy: Services you can benefit from and services to avoid

    Physical Therapy: Services you can benefit from and services to avoid

    Many of us at one time or another need physical therapy, particularly after a surgery or injury, to help us build our muscles, use our joints and move properly, while easing pain. It is often prescribed for people getting hip, knee or ACL replacements, people with arthritis or stroke. And, most insurers, including Medicare, cover some physical therapy services. To get the most of your care, make sure you are getting needed therapy; according to Choosing Wisely and Consumer Reports, certain therapies in some instances may do more harm than good:

    1. Heat and cold treatments: Ice packs and heated pads at home can provide short-term pain relief. But, beware of deep-heat machines, such as ultrasounds, for arthritis of the knee. Tailored exercise programs can be far better for you. It’s often best to move as much as possible.
    2. Strength training for older adults: It’s important to build muscle through exercise and movement or you can find yourself struggling to walk and balance as you age. Strength training should be challenging in most cases in order to build muscles, even for people who are not strong. If an exercise is easy, it is not likely working. Be sure your form is correct. If your knees or other joints are inflamed, then you should avoid challenging exercises.
    3. Treatment for blood clots: Often people are told to lie in bed if they are post-surgery and at risk for a blood clot. However, staying in bed does not help. Medicine is the chief treatment for Deep Vein Thrombosis or DVT.  You are no more likely to keep a clot from traveling into your lungs and preventing blood flow, (a pulmonary embolism) by staying in bed than by being active. And, being active is generally better for you once the anti-clotting drug takes effect. Remaining in bed can actually make a clot bigger and weaken your system.
    4. Exercises after knee replacement: Usually you will begin moving your knee within a day of surgery with help from a physical therapist, who will provide you with exercises. Moving also lowers your chances of getting a blood clot. If your doctor recommends you use a Continuous Passive Motion machine, ask questions; the evidence shows that it does not ease pain or help improve your quality of life; exercise delivers better results at lower cost. Of course, exercise is usually a key way you can improve your health, along with that of your partner.
    5. Wound care: Never use a whirlpool for wound care; there is no evidence that it works, and it can cause infections. Bacteria can spread easily to an open wound. If it does, then you are likely to get an infection, for which you will need to take antibiotics. It’s better to keep the wound clean and sterile and not expose it to bacteria that can cause an infection and possibly get into your blood stream.