It is not uncommon to hear complaints about increased joint pains and stiffened muscles plaguing the lives of elder people especially in winters. The main cause is due to the drop in atmospheric pressure. When the pressure decreases, there is swelling in the tissues and tension between the joints, which causes pain. The fluid inside the joints which is responsible for lubrication and smooth movement also gets influenced, and can create friction and tension on movement. Moreover, any undue pressure on the stiffened tissues might cause inflammation and internal swelling.
Joint problems gradually start with a little niggle in the knee which progresses over time, and starts to grow with occasional knee locks. The pain is often associated with swelling in the knee that occurs due to friction when the cartilage (polish) gets rubbed off. The treatment may vary from just medication, removal of fluids from the joint, to knee replacement surgery— this solely depends on the severity of the condition.
Joint replacement surgery is a common treatment for severe bone and joint pains in elderly. Hip replacement and knee replacements are the most frequently performed of these surgeries and are most often done in the people between the ages of 55 and 80. There has long been a popular conceit that older age automatically excludes people over 80 from joint replacement surgery due to anaesthesia complications and fragile bones.
But age alone is not a contradiction, there are other eligibility aspects which a surgeon will focus on, such as, physical health, associated health risks, or comorbidities. Severe osteoporosis may make it impossible to perform the surgery because the bones might be too brittle to support the new joint prosthetic in elderly age. While mild to moderate osteoporosis might not be a problem, however it depends on how a surgeon performs the surgery.
Implant surgeries are not always necessary for arthritis or knee and joint pains. But it may be worth considering if your knee is damaged by arthritis and the pain, disability or stiffness are impacting your daily activities severely. However, even with such pain experts will always try other measures before suggesting a knee replacement, including drug treatments, physiotherapy and exercises. If symptoms are manageable and medication is effective than surgery is not required. However, seeking expert opinion is always advisable.
Similar to the above point, there are several myths regarding joint replacement surgery which are stated below along with facts.
Myth 1: Joint replacement surgery means a long hospital stay
Fact: There have been big advancements in joint replacement surgery departments. Average hospital stay was up to ten days in the hospital after joint replacement surgery earlier, but today the average is three-four days. With improvements in technology and patient care, hospital stays are significantly shorter than before and even day care TKR (Total Knee Replacement) is being performed where the patient can come and go the same day of the replacement. However, there are certain limitations which concern the validity of eligible patients for a day care facility.
Myth 2: You should wait as long as possible before having a joint replaced
Fact: Waiting too long can make things worse. If your pain is so great that it's hindering your ability to walk, then you're not keeping your muscles and your extremities strong. You are only hindering the recovery process. Waiting for their mobility and quality of life to decline, patients should get their knee or hip replacement soon. This will likely improve their outcomes.
Myth 3: Implants don't last long in obese people
Fact: Knee replacements can be successfully done in obese patients as well. With painful arthritic joint, it is very difficult to lose weight as the patient is less mobile. Therefore, many patients actually lose weight after surgery as they are able to participate in brisk walking and exercise program after knee replacement.
The writer is Dr Ramneek Mahajan Director, Orthopaedics and Head Joint Reconstruction (Hip & Knee) Unit at Max Smart Superspeciality Hospital, Saket, New Delhi