Knees Archive

The idea of having a knee replaced is daunting. But what if both of your knees need repairing? Is one visit to the operating room better than two?

If you are otherwise in good health, it's a conversation worth having with your doctor and rehabilitation team. There are some benefits to replacing both joints during a single surgery (called simultaneous replacement). These include undergoing anesthesia only once, fewer days in the hospital, and only one (albeit prolonged) rehabilitation that lets you resume normal activities sooner than two separate ones. 

Image: Thinkstock

Ask the doctor

Q. I occasionally use a brace on my knee because I have knee arthritis. Am I weakening my knee?

A. The benefit of a brace for knee arthritis is likely in the eye of the beholder. A brace can help improve the ability to perform certain activities, and for some people the compression and warmth of the brace relieves pain. However, medical research has been mixed on the absolute benefits.

If knee pain and swelling are severe an are not getting better, see your primary care doctor for a thorough evalucation. Image: Thinkstock

Arthritis is not the only possible cause of knee pain, swelling, and disability.

Joint replacement is a complex procedure, and finding the right surgeon and hospital can make a big difference in your outcome. In general, you're likely to have a better result and fewer complications if your surgeon performs the operation frequently (at least 100 times per year) and operates in a hospital where these procedures are commonplace. Don't be surprised if this rules out the most convenient hospital for your location.

Your orthopedist, rheumatologist, or primary care physician, or a friend who has undergone successful joint replacement, may be able to recommend a specific surgeon. But keep in mind that your insurer may restrict you to certain specialists or require a larger copayment if you go outside your plan.

Physical therapy is helpful for wear-and-tear knee osteoarthritis, especially if you start doing it early. But injecting a painful knee with an anti-inflammatory steroid medication before starting physical therapy offers no additional benefit, according to a clinical trial in JAMA Internal Medicine.

Studies have shown that physical therapy modestly reduces pain and improves daily functioning in people with knee osteoarthritis. That could mean being able to walk farther with less pain or to continue leisure activities such as gardening. Before you start physical therapy, your doctor may offer to inject the knee with a cocktail of anti-inflammatory steroid medication and an anesthetic. Hypothetically, this could make it easier for you to stick with exercise and therefore lead to better results.

Knee replacements can restore your mobility, but you don't want to get one too soon—or wait too long.

Physical therapy and weight loss can relieve knee pain and protect your mobility.

The pain from an arthritic knee can be intense, limiting daily activities and independence. Men can try a range of medications, but overall acetaminophen (Tylenol, other brands) appears to relieve pain only slightly better than a placebo pill, according to a research review in Annals of Internal Medicine.

The researchers pooled results from 137 randomized clinical trials involving about 33,000 people with knee arthritis and compared the relative effectiveness of the following treatments:

Mobility relies on the body's two largest joints, the hips and knees. We ask a lot of both these joints: they must bear our full weight and coordinate movement over a lifetime of standing, walking, running, dancing, and sports. Not surprisingly, hip and knee pain are common complaints, and nearly everyone who lives into old age can expect some trouble with these joints. But taking care of your hips and knees and managing any pain that arises will help you avoid losing mobility as you age.

Try these self-help measures when knee or hip pain strikes:

Don't rush into it, but don't wait longer than you need to.

More than 700,000 Americans will have one or both knee joints replaced this year, usually because of damage from wear-and-tear arthritis. Age itself is no barrier, and about half of total knee replacements go to people 65 and older. Replacing a joint damaged by osteoarthritis helps men stay active and independent.