I have been a runner for most of my life and, as would be expected, I am now experiencing a knee problem. It appears from an X-ray that there is no bone issue, so it must be soft tissue. The knee is a very complex part of our body and each interconnecting part is vital to the smooth movement of what really props up our bodies. I have looked at the options for someone with a knee problem. They are not always as rosy as they appear.
Joint replacement, or ‘arthroplasty’, as doctors term it, is justifiably regarded as miracle surgery. Medicine offers knee replacement surgery as the inevitable next step when pain and immobility become too great. According to a study presented at the American Academy of Orthopaedic Surgeons in 2016, knee replacement has become so commonplace and popular that the number of annual surgeries is expected to rise by 673 per cent over the next 20 years.
During the operation, the surgeon removes damaged cartilage (the soft tissue lining of the joint) plus a small amount of bone. An artificial joint made of metal and polyethylene is then cemented into place. A patient with no complications usually spends around five days in hospital and a month recuperating at home, with the possibility of returning to normal activity over the course of two to three months.
The medical research paints a glowing picture of knee replacements, claiming that 95 per cent of knee operations, using cement, are successful, that is without any complications, for at least 10 years. According to a review by the Indiana University School of Medicine, of 130 studies, 89 per cent of knee replacements have a good outcome over an average follow-up period of more than four years. The majority of knee replacements remain functional for at least 10 years.
However, this track record refers to the knee replacements that ‘take’ and omits all the problems that could arise. Briefly, here is what needs to be taken into consideration before committing to the procedure:
Do you really need it? Researchers from the Virginia Commonwealth University in the US say only 44 per cent of procedures are fully justified.
An artificial knee will only last about a decade before wearing out. So if you are under 60, you will face having to undergo several more ‘revisions’ in your lifetime
Serious complications are more frequent than are reported. The Indiana University review came up with the following complications: superficial and deep infections, pulmonary embolism, deep venous thrombosis and nerve damage to a limb.
Unless you are very old, the knee replacement will wear out. In the Indiana study nearly one in 25 people had to undergo knee operation ‘revisions’, which meant having the artificial knee replaced with a new knee joint. This occurred after less than four years in those affected. In fact, an artificial knee will only last about a decade before wearing out. So if you are under 60, you will face having to undergo several more ‘revisions’ in your lifetime.
Artificial knees often come loose. A Finnish survey of 33 studies discovered that joint loosening was the main reason for revision, and also its main complication. Another problem was bacterial infection.
There are many other considerations, but space restricts me, so, ultimately, surgery can help elderly people regain mobility when there is no other alternative to a wheelchair. However, for everyone else it makes sense to do everything possible to avoid going under the knife.
What to do instead? Here are some brief suggestions:
• Modify your diet and identify any hidden allergies or parasites. Increasingly, connections are now being made between the state of your gut and the amount of inflammation in your joints.
• Don’t ignore the power of glucosamine sulphate and chondroitin. Glucosamine is the major building block of proteoglycans, the large molecule in cartilage that makes it elastic and protective. This maintains joint lubrication and flexibility by trapping water in the cartilage matrix. Chondroitin helps maintain joint fluidity, while slowing cartilage damage and helping to repair it.
• Consider acupuncture for pain relief. Danish doctors looked at acupuncture patients who were scheduled for surgery because of severe knee osteoarthritis. Even in the most advanced cases, monthly acupuncture relieved as much as 80 per cent of the pain and significantly increased knee movement.
• Try supplementing with hydrolysed collagen and MSM. In lab studies collagen hydrolysate was found to stimulate the synthesis of collagen in cartilage tissue, while MSM (methylsulphonylmethane) improved pain and function over a 12-week trial.
• Investigate electromagnetic therapies. Pulsed electromagnetic field (PEMF) generators are particularly promising for patients suffering from chronic pain. PEMF generators, which include wearable devices designed for virtually continuous use, as well as high-powered machines meant to be used several times a day, can help osteoarthritis sufferers. PEMFs have well-documented physiological effects, including increasing levels of glycosaminoglycan.
• Finally look at stem-cell therapy. In this increasingly popular procedure, a patient’s stem cells are extracted, cultured and then reinjected into the damaged knee. Dr Chris Centeno of the Centeno Schultz Clinic, Colorado, US, which pioneered the procedure, advises to opt for a procedure that uses mesenchymal stem cells (MSCs). They are considered superior because they are already partially committed to becoming bone, muscle, ligament or tendon, they are also easily harvested from bone marrow and reproduce rapidly. This makes them ideal for repairing the structures in the knee.
In conclusion, there is a lot to consider when you find your knee is about to give up on you.
kathrynmborg@yahoo.com