Knee Joint Issues in Seniors: Is Surgery the Only Solution?

Knee joint issues in the elderly?

My mother-in-law experienced knee joint pain in August of this year due to prolonged kneeling during a family mourning period.
Initially, she thought it was a minor pain and self-treated with herbal remedies.
However, about a month later, she noticed a significant increase in pain and sought treatment at the hospital.
After more than two months of treatment, the pain has decreased, but she still walks with a limp.
She is currently undergoing treatment and is taking the medication prescribed by her doctor, as well as glucosamine.
The doctor has recommended knee joint replacement surgery.
Is it necessary for her to undergo joint replacement surgery? She has always been healthy and rarely used her health insurance card.
Should she consider getting a second opinion at another hospital? I also read in the newspaper that hyaluronic acid injections can be effective; is that true? Thank you.

Mei Mei, 40~49 year old female. Ask Date: 2010/11/14

Dr. Shi Guozheng reply Orthopedics

Patients who typically require knee arthroplasty have often experienced pain for a considerable period, and X-rays show more severe changes.
Additionally, they must undergo medication treatment for a duration of three to six months.
Only after these methods have been tried and proven ineffective should knee replacement surgery be considered.
Seeking a second opinion from another physician is a good suggestion.
If knee arthroplasty is indeed necessary, minimally invasive surgery is recommended, as it allows for quicker recovery, less pain, shorter rehabilitation time, and better outcomes.

Reply Date: 2010/11/14

More Info

Knee joint issues in seniors can be quite complex, and the decision regarding surgery, particularly knee replacement surgery, should be approached with careful consideration. Your grandmother's situation, where she developed significant knee pain after prolonged kneeling, is not uncommon. It is essential to understand the underlying causes of her pain and the potential treatment options available.

Firstly, it is important to recognize that knee pain in seniors can stem from various conditions, including osteoarthritis, meniscus tears, ligament injuries, or even inflammatory conditions like rheumatoid arthritis. Given that your grandmother initially experienced pain after a specific activity, it is possible that she may have exacerbated an existing condition or developed a new one due to the strain.

Regarding the treatment options, surgery is often considered when conservative treatments fail to provide relief. These conservative treatments may include physical therapy, medications (like NSAIDs), corticosteroid injections, and lifestyle modifications. Glucosamine supplements, which your grandmother is taking, are sometimes used to help with joint health, although the evidence supporting their effectiveness is mixed.

In your grandmother's case, if she has been undergoing treatment for over two months and is still experiencing significant pain and difficulty walking, it may indicate that her condition is more severe than initially thought. The recommendation for knee replacement surgery typically arises when the pain is debilitating, and the patient's quality of life is significantly affected. However, surgery is not the only solution, and it is crucial to explore all options.

Before proceeding with surgery, it would be wise to seek a second opinion from another orthopedic specialist. Different doctors may have varying approaches to treatment, and a second opinion can provide additional insights into whether surgery is indeed necessary or if other treatments could be effective.
Additionally, you mentioned the possibility of hyaluronic acid injections, which can be beneficial for some patients with osteoarthritis. These injections aim to provide lubrication to the joint and may help alleviate pain and improve mobility. However, the effectiveness can vary from person to person, and it is essential to discuss this option with a healthcare provider.

In summary, while knee replacement surgery can be a viable solution for severe knee pain and dysfunction, it is not the only option. It is crucial to evaluate your grandmother's specific condition, consider all available treatments, and possibly seek a second opinion to ensure that she receives the most appropriate care. Engaging in physical therapy, exploring non-surgical interventions like injections, and maintaining an active lifestyle within her limits can also contribute to her overall knee health and quality of life.

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