Myths and Truths about Knee Arthroplasty

More and more people are undergoing knee replacement surgery as prolonged life expectancy coupled with modern lifestyle favors wear and tear.

According to the Organization for Economic Cooperation and Development (OECD), total knee arthroplasty is one of the fastest growing operations in the world. Between 2000 and 2013, the number of knee arthroplasty surgeries almost doubled, with an average of 121 per 100,000 people now undergoing surgery.

In practice, this means that in the 35 OECD Member States, including our country, there are almost 1.6 million knee arthroplasty surgeries a year, with a total population of 1.29 billion.

Although knee arthroplasty is so common, many myths still surround it, some of which are related to the procedures and materials used per se and others to their effects.


Myth No. 1

The patient must wait until he or she cannot walk at all.


The truth: When the knees are severely damaged by arthritis or injury, the patient may find it difficult to perform simple activities, such as walking or climbing a ladder, because they exhibit symptoms such as pain, stiffness and swelling. At first, these symptoms are treated conservatively, e.g. with weight loss (when available), physiotherapy, exercises to improve joint mobility and flexibility, pain and stiffness control (e.g. with cold or hot patches, massages, painkillers). However, when symptoms reach a level at which they do not adequately respond to precautionary measures and interfere with the patient’s life (e.g. being restricted at home because of pain, assisted walking), consideration should be given to the option of arthroplasty. The same is true if the knee starts to deform or if symptoms persist even when the patient is motionless or lying down and/or obstruct sleep at night.


Myth No. 2

Total knee arthroplasty should be performed after the age of 60 years.


The truth: There is no age limitation in performing the surgery because its criterion is not age but pain and other symptoms of the patient. Most people with total knee arthroplasty are 50-80 years old, with at least 30% of them under 65 years of age. In fact, over the last decade, more and more people in their 30s or even 20s have been operated with severe knee damage, not only due to injuries (e.g. in sports or traffic accidents) but also due to severe (morbid) obesity.


Myth No. 3

Arthroplasty should be delayed as much as possible, because the new joint only lasts for 10 years.


The truth: An artificial knee joint usually lasts much longer than a decade, but it depends on the use and the weight of the patient. With normal use and activity it can last for many years, but with excessive activity and obesity the deterioration of the artificial joint is accelerated. This is why it is recommended, for example, to avoid high impact activities (e.g. jogging) and daily occupation with gentle exercises (e.g. walking, swimming, golf, light hiking, indoor dancing and cycling). International studies have shown that 95% of patients who avoid exaggeration preserve the new joint for 15-20 years.


Myth No. 4

Recovery from surgery may take several months.


The truth: It depends on the type of arthroplasty, the specialty of their doctor and the postoperative care the patient will receive. With minimally invasive arthroplasty, most patients return home 2-3 days after surgery and continue the rehabilitation program there. However, immediate mobilization of the patient after surgery is crucial to the outcome of the procedure, according to the American Academy of Orthopedic Surgeons (AAOS). Patients should start walking during the first postoperative days and perform special exercises several times a day. In addition, they should be able to fully undertake most of their daily activities within 3-6 weeks. For several weeks after arthroplasty, they may feel some pain during movement and during nighttime, but pain can be controlled. Return to sports is one that can be the most delayed.


Myth No. 5

With the artificial joint the knee will bend less.


The truth: Many people believe it, but it is not true. Many types of artificial joints have the same range of mobility as a natural knee, but whether or not they will fully work depends on the skill of the surgeon who places them and on the postoperative rehabilitation that the patient will perform. For example, a patient who is afraid to move around and spends the day sitting still in a chair will not have as good knee mobility as another who exercises his or her leg several times daily.


Myth No. 6

Arthroplasty on both knees may not be performed simultaneously.


The truth: Of course it is feasible, but various factors are taken into account when making such a decision, as it has certain disadvantages (e.g. greater blood loss, the patient will not have a “good” leg to support body weight, etc.). Bilateral arthroplasty is usually performed to younger patients and to those who are in good physical condition and in good general health.