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Preventing Knee Replacement Surgery

Right around the 6th and 7th decade of life, quite a few of my patients face the decision of a joint replacement, often the knees. In this article, I’ll discuss preventing knee replacement surgery since it’s one of the major surgeries many will have in their lives.

Understanding Osteoarthritis

The main reason people end up with knee replacement surgery is because of advancing osteoarthritis, commonly referred to as just arthritis.

This is a degenerative joint disease in which the joint surface starts breaking down. This limits the normal range of motion of the joint and causes a lot of pain—though not in everyone, which I’ll discuss below.

Okay, so we grow up being active, and at some point, we gain some weight, and then we go through a few years of being sedentary. The sedentary years cause a lot of muscle loss and affect the stability of the joint. These weaker knees suddenly get a good pounding when we try to use them again for doping chores or exercising.

Osteoarthritis is definitely preventable, and that’s an important point to consider. Of course, everything is said to be preventable these days, which often just causes more blame stress on the patient. So, let’s not go down that rabbit hole; instead, let’s focus on what is important to you and your health.

How to Prevent Osteoarthritis

Again, we assume that joint replacements are performed mainly by advancing osteoarthritis. Preventing OA will, therefore, prevent the need for a joint replacement.

It’s never too late to start because osteoarthritis, by definition, is a progressive degeneration of the joint. The pain you experience now could diminish by as much as 80%, and, for some people, it could be completely relieved by having the right lifestyle routine.

1. Work on Joint Stability

Each joint in the body, such as the knees, requires a certain range of motion. The joint alignment must follow a trajectory for it to function properly.

We don’t want the wrong surfaces to contact each other. You can achieve this by fine-tuning your stability—also called proprioception.

Stability exercises are often done using single-legged exercises or walking on uneven surfaces. You want to work yourself up to this, or else your knees can take a beating.

2. Be Able to Carry Your Weight

However much you weigh, your knees must be able to carry the load placed on them. Whether you’re 125 lbs or 420 lbs, if you don’t have adequate muscle mass and flexibility, your knees will constantly get damaged from the axial load of your bodyweight.

Strengthening the knees is quite important, and many of my knee osteoarthritis patients try to avoid it. They believe the pain they feel when working out their knees is harming them.

But pain isn’t the same as hurting. We might feel a healthy dose of pain when exercising osteoarthritic knees, but we aren’t necessarily doing damage. Over the long run, resistance training will help regenerate healthy joint tissue.

High‐quality evidence indicates that land‐based therapeutic exercise provides short‐term benefit that is sustained for at least two to six months after cessation of formal treatment in terms of reduced knee pain, and moderate‐quality evidence shows improvement in physical function among people with knee OA.

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3. Decrease Inflammation

We’ve addressed inflammation in other articles; anytime we can decrease inflammation, it’s much more likely to develop healthier joint surfaces and prevent knee replacement surgery.

Sure, serum biomarkers can measure inflammation. But we can also use acne, bloating, fatigue, eczema, dry eyes, and many other symptoms to gauge our inflammatory state. Preventing knee replacement surgery requires us to control the amount of total body inflammation we have.

The goal of controlling inflammation is to decrease the amount of cartilage and synovial damage we incur. Though a slight amount of local inflammation can help regenerate knee cartilage and joint tissue, systemic inflammation needs to be avoided.

4. Allow For Joint Healing & Recovery

Physical therapy, exercises, stretching, balance work, and stability exercises are all important to help heal osteoarthritis in the knee. But we also need time for the tissue to heal after a particular workout.

Rest is just as important for preventing knee surgery as is the exercise. How much rest do you need? Depends on how much local inflammation you feel after a workout. Pain, swelling, redness, stiffness, and achiness are symptoms of local inflammation. This often will go down without about 2-3 days but may sometimes need as much as 10 days.

5. Address Mobility Limitations

If the ligaments and tendons around the knee are tight, the knee can’t move in all its necessary dimensions. The muscles around the knee have to be strong but also have the right amount of give.

Stability work is important, as is muscle strengthening around a joint. If the knee isn’t able to extend or flex all the way, that’s worth addressing through mobility exercises.

6. Consider Dietary Changes

Late-night eating makes me bloated. Alcohol tends to wreck my body when I haven’t gotten enough sleep or not exercising enough. I can handle gluten perfectly in small amounts, but as soon as I go over my limit, I’m a giant puffball.

Dietary inflammation can be tracked using a mood-food-poop journal. Most of us know which foods give us acne, pain, stiffness, bloating, brain fog, and fatigue.

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