A knee replacement is when components of the knee joint, such as the cartilage, are surgically replaced with an artificial prosthetic. Oftentimes knee joint prosthetics are made of metal, plastic, or a combination of the two.
Replacing the worn out components of the knee can offer immediate relief from pain in some cases but often can also lead to ongoing discomfort.
In this article we are going to investigate how knee problems may occur, what a knee replacement entails, and knee replacement alternatives to consider before undergoing surgery.
Knee Replacement Statistics
There are roughly 600,000 knee replacement surgeries carried out in the United States each year (1). Knee replacement cost varies from $15k to $50k with an average cost of about $30k. While having this procedure done can alleviate pain and provide some additional mobility, many people report feeling chronic pain or permanent restriction after knee replacement.
The best age for a total knee replacement according to many doctors is around 60 years old. This is because the metal and plastic apparatus used to replace the knee sometimes only lasts about 15-20 years. If a knee replacement goes bad, then you may need to undergo a second knee replacement.
While this procedure can be absolutely necessary in some cases, there is an increasing need for knee replacement alternatives.
Why Are Knee Replacements So Common?
According to the CDC, there was a significant linear trend upward in the number of total knee replacements performed each year from 2000 through 2010 (2). At the same time, it was observed that the average age of those receiving knee replacement was decreasing during that time. Essentially, more people are getting knee replacements and they’re getting them at a younger age as time goes on. That's not good.
Why are our knees so prone to damage and chronic inflammation?
Here are some common potential scenarios.
It is hard to pin down a specific cause, but any number of scenarios can predispose someone towards needing to have a knee replacement later in life. For example, if you were extremely active in your younger years and built a habit of overtraining without adequate recovery, this could increase your chances of needing a knee replacement. Especially if your training involved heavy impact or improper force being placed on the knee joint.
Other potential contributors could include:
- Making a habit of ignoring pain and stiffness in the knee joint during workouts or everyday activities
- Making a habit of constantly locking out your knees rather than using your muscles to support the knee joint
- Being sedentary for an extended amount of time
- Having pain in other areas of the body that you alter your movement patterns to avoid, leading to poor mechanics at the knee
- Being overweight (3).
While losing weight will certainly help, another critical solution on the list of alternatives to knee replacement is improving your biomechanics to change the way your knee handles different forces.
As we have tested many times, how someone stands and moves influences the forces that occur at the knee. When someone can learn to engage their muscles properly to stand and move better, their knee pain often goes away.
While in many cases knee replacement is necessary, biomechanics training and correction should be one of the knee replacement alternatives considered before a final decision is made. Especially when you consider knee replacement cost and the potential side effects.
Knee Replacement Recovery Time
The typical knee replacement recovery time is around 3 months or 12-weeks.
During those 12 weeks, patients are typically given a set of physical therapy exercises to perform that are designed to increase range of motion and strength of the knee.
After 12 weeks, patients are often cleared to begin returning to their normal physical activity while monitoring pain levels and other signs of inflammation like excessive swelling.
Some of the permanent restrictions after knee replacement include not partaking in long-distance running, jumping, sports that require quick direction changes or heavy weight-bearing.
Disadvantages of Knee Replacement Surgery
90% of knee replacements last at least 15 years and 82% last for at least 25 years (4). While this may seem promising, this doesn’t mean that those years are completely symptom-free. It has been estimated that around 20% of people who have had a knee replacement experience lingering pain and stiffness (5).
In fact, the number one complaint after knee replacement is chronic knee stiffness. Because of this, the majority of those who have had the procedure done report an inability to perform a kneeling motion.
Other less-common complications of this procedure are the implant coming loose, infections, and blood clots.
In addition to the potential side effects, the knee replacement cost is quite hefty. Especially to potentially then deal with chronic knee stiffness the rest of your life.
In addition to monetary cost, there are unconsidered peripheral side effects including:
- Not being able to work for a period of time
- Having to rely on anti-inflammatory or pain medication to get through the day
- Developing additional movement asymmetries and pains at the hips or lower back as a result of poor mobility at the knee
- Not being able to interact fully with children or grandchildren due to the inability to kneel on the affected knee
That being said, in some cases it is probably absolutely necessary.
Luckily, biomechanics training may be the best way to overcome some of the disadvantages of knee replacement surgery. By improving the way you move, you can eliminate inappropriate forces on the knee, reduce chronic inflammation and allow a healing response to occur.
The following are a couple of scenarios in which improving movement led to a reduction in knee pain and improved athleticism:
To following articles go more in depth about the origins and potential solutions for knee pain:
Summary: Alternatives to Knee Replacement & How Can I Fix My Knees Without Surgery?
Is it worth getting a total knee replacement?
Maybe. That is ultimately your decision.
While this procedure has absolutely improved lives, biomechanics training is one of the knee replacement alternatives that may be worth trying first or considering in your recovery.
This is because your posture and the way you move determines what types of force your knee will endure. When people move well, their joints tend to last longer. This has a lot to do with how some people can live very long and athletic lives without ever needing a knee replacement.
- Healthline: Knee Replacement Surgery Success Rate, Statistics, and Outcomes (LINK)
- CDC: Hospitalization for Total Knee Replacement Among Inpatients Aged 45 and Over: United States, 2000-2010 (LINK)
- Wall, C.J., de Steiger, R.N., Vertullo, C.J., Stoney, J.D., Graves, S.E., Lorimer, M.F. and Kondalsamy-Chennakesavan, S. (2022), Obesity is associated with an increased risk of undergoing knee replacement in Australia. ANZ Journal of Surgery, 92: 1814-1819. https://doi.org/10.1111/ans.17689 (LINK)
- Evans JT, Walker RW, Evans JP, Blom AW, Sayers A, Whitehouse MR. How long does a knee replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Lancet. 2019 Feb 16;393(10172):655-663. doi: 10.1016/S0140-6736(18)32531-5. Epub 2019 Feb 14. Erratum in: Lancet. 2019 Feb 20;: PMID: 30782341; PMCID: PMC6381229. (LINK)
- Wylde V, Beswick A, Bruce J, Blom A, Howells N, Gooberman-Hill R. Chronic pain after total knee arthroplasty. EFORT Open Rev. 2018 Aug 16;3(8):461-470. doi: 10.1302/2058-5241.3.180004. PMID: 30237904; PMCID: PMC6134884. (LINK)