They say ‘Ignorance is bliss’! But can you imagine going under the knife with no knowledge of the surgeon or surgery? Unfortunately, half-knowledge is worse than ignorance. We see so many patients with pre-conceived notions about replacement surgery and most of them are untrue. Two decades of the unabated, wilful spread of fear and panic combined with lack of patient empathy and education has resulted in public-at-large shunning the idea of knee replacement surgery. Orthopaedic Knee Surgeon, The Knee Clinic, Dr Miten Sheth dispels some myths regarding knee replacement.
Myth: Osteoarthritis can be reversed
Fact: Osteoarthritis is an eventual outcome of the ageing of your knees and ageing cannot be reversed.
A good analogy here is to compare cataract of the eye with osteoarthritis of the knee. The lens in most eyes and cartilage in most knees grow old in the sixth and the seventh decade. This leads to reducing eyesight and increasing knee pain. Unfortunately, current science does not offer any solutions for reversing this degeneration.
Myth: Human parts of the body cannot be replaced
Fact: Parts of the body (including knees) that cannot be repaired need to be replaced if you want them to last as long as the other parts!
Let us compare lungs, liver or kidneys with knees. Smoking, alcohol, diabetes and ‘sometimes no reason at all’ may damage lungs, liver or kidneys beyond repair. Transplants then are the only meaningful solution. Similarly, rheumatoid arthritis, obesity, hereditary risk and most of the times ‘just plain ageing’ may damage knees beyond repair. Replacement then is the only feasible solution. There may be temporary ways to buy time like dialysis and taking painkillers or cartilage supplements. But the fact remains that we do not have a permanent solution yet.
Myth: Knee replacement fails most of the times
Fact: Knee Replacement is successful surgery. What is the success rate? We now know that approximately 90-95 per cent of knee replacements are successful for 10-15 years and more than 85 per cent of knee implants last for 20-25 years. The body accepts artificial metal components and almost always allows them to integrate with native bones. Metal allergy is a very rare, almost unseen cause of failure.
Myth: Knee replacement can be very painful
Fact: Knee Replacement is not as painful as one can imagine. Think of delivery pain and if you imagine it to be unbearable, you are dead right. Conversely, pain after knee replacement surgery is well monitored, controlled and almost always less than what one expects. Complaints do linger till about six (sometimes nine) months after surgery, but it is an ever-improving process. In fact, in medical parlance, we have something called as the ‘Forgotten Knee Score’ where we expect the knee to function almost like the original about a year after surgery.
Myth: Knee surgery can be 100 per cent successful
Fact: Surgeons are not vendors and there is no such thing as a 100 per cent guarantee.
Human bodies are not commodities. Hence it is difficult to predict which subset of patients may remain unhappy. Medical care cannot offer money-back policies but most doctors empathize and are partners in their patients’ surgical-recovery journeys.
There are just three things that eventually decide surgical success.
1. Patient (motivation and confidence)
2. Surgeon and Surgery (it’s the patient’s choice)
3. God Almighty (luck for non-believers!)