Joint replacement is the final solution for arthritic joint pain. Many surgeries now involve partial joint replacement, as it is common to only have one part of the knee that is badly damaged. This is less invasive surgery so that there will be less scarring, a shorter stay in hospital and a quicker recovery. Up to the point where arthritis is so severe that there is little or no smooth cartilage lining the joint, keeping active with the right kind of exercise and working to keep the muscles strong around the joint can have a very positive impact on managing pain and delaying the need for joint replacement surgery.
Although it might seem counter-intuitive to exercise on a joint that is osteo-arthritic, both medical evidence and my personal experience as a physiotherapist have proved this to be the right approach. It is essential to have a regular programme of exercises to do to keep the knee joint moving and the muscles around it strong as well as knowing what general exercise is good and bad for arthritic knees. Physiotherapists can advise on this from the early stages and diagnosis of osteo-arthritis right through to the point of needing joint replacement surgery and then afterwards to help rehabilitate. As surgery is a major intervention and the lifespan of a new joint is not infinite, it is offered as a solution and only recommended when pain becomes unmanageable. It makes sense to put it off for as long as possible. Many people with osteo-arthritic knees who have never tried physiotherapy or exercises are amazed at the reduction in pain and swelling and improvement in movement that they can achieve with the right management, allowing them to delay surgery for months and even years.
I have personal experience of this, having injured my knee badly over 20 years ago in an awkward fall involving two dogs and a baby in a backpack. The injury that I sustained meant that, about two years later, I needed to have a large area of the protective cartilage that lines my knee joint removed. Over many years since this operation, I was still able to live a very active life with no knee pain. I was fortunate that my knowledge as a physiotherapist allowed me to manage my knee and adapt my exercises and activity accordingly as the years passed and the inevitable arthritis (because of the removed cartilage) in my knee progressed.
In January 2020 I had a total knee replacement. I had managed well despite the end stage arthritis in my knee for a long time and was able to be remarkably active considering the extent of the damage to my knee joint. Continuing to exercise, gradually progressing what I was able to do after my surgery and having the confidence of my physiotherapy knowledge has helped me make a rapid and good recovery from the surgery and I am remarkably pain-free and back to active life, work, dog walking several miles daily, cycling and even getting back to playing some gentle tennis four months after the operation.
Having had my own personal experience of this surgery and the arthritis that precedes it has shown me personally the power of good physiotherapy for optimal pain management before and for the ability to be able to make a good recovery after surgery.
I feel privileged to able to know first hand what my clients who suffer osteo-arthritic knee pain are going through… having to tackle those stairs again on a bad day, even on a good day...broken nights, how hard can pavements be?...getting out of a cinema and down those steps after all that sitting... not easy… the inexorable slide into sensible shoes. I also know how it feels to face that surgery, to try and make the decision on when is the right time to have it done, how it actually feels to have it done, how it feels afterwards and how to fill in the gaps in the rehab that a sheet of paper given in hospital cannot possibly fill for each individual. I know that not everybody’s experience is the same, but I hope that my experience has enhanced my ability to understand, over and above the medical theory, what it means to have this condition and to undergo and then recover from the surgery to relieve it.
If you have knee pain or osteo-arthritis, are considering knee replacement surgery, either total or partial and would like physiotherapy advice and guidance, please press here to contact us
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