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Risks Of Knee Replacement Surgery And Osteoarthritis

Updated on December 28, 2015
Knees are most important for our mobility.
Knees are most important for our mobility. | Source

Joint Animation

Positve and Negative Outcomes

In this article, I can provide first person experience with individuals I have known that suffered knee problems, along with some useful links to additional information.

I have known several people over the last twenty years that have experienced severe arthritis in their knees and/or hips. Several of them underwent knee replacement surgery. Some of these surgical patients had extremely good outcomes and some have suffered increased pain and difficulty walking after their surgeries. One lady with whom I worked was in her late seventies and kept the same set of knee replacements for over 25 years and reported no difficulty walking. Staying active and working until the age of 80 helped a lot.

One woman I know refuses to have any surgery at all despite severe hip and knee pain, while another woman I know gained enough relief through exercise, herbal medicine, and dietary changes that her condition improved very much. In fact, the physicians of this last women state that she no longer suffers from arthritis.

Certain types of arthritis can sometimes be reversed if not too far progessed, but not often at this juncture. It ould eb difficult to reverse the deterioration of osteoarthritis. However, research is under way to make this more of a possibiity and even a reality for a certain number of patients in the future.

Meanwhile, dramatic improvements are being made to knee replacement parts. In the late 1980s, The Ohio State University developed a ceramic based knee replacement that was reported to last a lifetime. This development, while not widely used to date, will be a boon to patients that have been instructed that they will need new knee replacements every 15 - 20 years. A number of people need their first replacement by age 50 and cannot face having it repeated twice in their lifetimes.

Another improvement is the development of different knee replacement for men and women,based in the difference between men and women in structure of the lower body and how the bones connect at the hips and knees. There has arisen some difficulties in using what is now seen as a "male" knee in female patients.

What Are the Complications Of Joint Surgery?


Cutting Edge Replacement

Mitigating Factors


On top of arthritis, a knee can become infected, showing signs of severe pain, joint swelling with heat or warmth, fevers, and inability to walk, bend the knee, or hold one's weight. This can occur with or without arthritis, but can worsen the overall knee condition if arthritis is already present. Infections can be mistaken for arthritis.


One of the factors that can affect the success of knee replacement surgery is body weight. Morbid obesity works against the successful rebuilding of joints in the legs. One patient I have known was not able to lose much weight before surgery and had a bad experience with their knee replacements that were to treat osteoarthritis (deterioration).

Despite physical therapy and leg exercises in step-down care after surgery, followed later by twice-weekly physical therapy sessions on an outpatient basis, the knees would not fully bend. The actual body tissue around the knees was too much and the knees also swelled, as did the feet. Swollen joints cannot bend well, if at all. When insurance ran out, physical therapy stopped for this patient and the knees began to stiffen even further.

Today, several years later, the patient is left able to walk only about 100 yards before having to stop and elevate the legs, cannot drive, and can rarely walk up the steps of a bus.

Further, after the first surgery, this person developed a large amount of scar tissue in both knees and had to have additional surgery to remove it three years later. The knees worked better until insurance ran out and physical therapy stopped.

This patient states that they would not have had the surgery if they knew their pain would be worse than previous to the operation. However, they had been told that their arthritis was so badly progressed that both the knees were "bone on bone" with no cartilage padding left at all.


It is possible that physical therapy needs to be administered at least 3 times a week in some cases, and prescribed exercises done daily without fail. I have worked with dozens of joint and back condition patients in my martial arts and fitness classes and found that once or twice a week sometimes produces no results. It's an individual matter, but I think the daily exercises are vital.


Wearing the wrong type of shoes can likely lead to joint problems before and after knee replacement surgery. Those folks that I have known that wore well-constructed shoes with a good arch support built in seemed to have had the best success. One of these women was able to put on 4-inch high heels for work 6 weeks after surgery.


One of my my back-pain patients in the Health Psychology department in which I worked was to have knee replacement surgery to relieve osteoarthritis that was connected to military service and subsequent military-related injuries. He went into the hospital for one knee only the first time.

When he awoke, he was informed that the knee replacement could not be accomplished, because the knee was in too deteriorated a condition. The bones had to be fused to eliminate the knee joint entirely. This had a great impact upon him physically and psychologically and he did not have surgery on the other knee.


Another patient suffered additional arthritis after knee replacement surgery. Arthritis spread somewhat into the remaining bones of the legs and progressed into the back and even into some muscles (certain arthritis can attack muscles). This patient felt worse off than before surgery.


Second and third opinions about the advisability of knee replacement therapy should be obtained and then the decision should still be carefully considered.

One item to consider is the type of hospital to which you will go for your surgery. Sometimes teaching hospitals can produce superior results. Sometimes totally orthopedic hospitals that specialize in these surgeries produce the most positive outcomes.

The best course of action is likely to read everything you can about knee replacement surgery, learn about the hospitals and doctors that will treat you, get a second and third opinion, and weigh all of the information carefully in making your decision.

Other Risks of Knee Replacement

  • Post-operative Infection.
  • Fractures in the bones of the leg during surgery, especially near the knees - Surgical cement is being used instead of metal screws in many cases and this damage is thereby avoided.
  • Blood Clots
  • Vascular disease associated with the tourniquet required on the leg during surgery
  • Tissue Death from over-long tourniquet use
  • Neurological Involvement - 1) a type of palsy in the legs and/or 2) Restless Legs Syndrome
  • Pain and Stiffness in some cases
  • Psychological involvement - depression particularly
  • Other

Alternative - Partial Knee Resurfacing

Making a Decision

If left untreated, arthritis in the knees can become crippling. Sometimes non-surgical treatment does not even work. However, sometimes knee replacement surgery is not as successful as it might be in certain cases. On the other hand, dramatic improvements in knee replacement parts and therapy techniques make for a better picture for the future of knee patients.

The keys are

  1. Patient education and
  2. A partnership between doctor and patient to work together for the best possible outcome in each unqiue case.


© 2008 Patty Inglish

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    • Josh Tam profile image

      Josh Tam 9 years ago from Kch

      I know a very inexpensive way to cure/avoid osteoarthritis. Sleep roughly at 10pm. At 10-12 at night, the body can replenish itself and rebuild worn-out tissues, including the knee. Providing you sleep at that time!

    • Zsuzsy Bee profile image

      Zsuzsy Bee 9 years ago from Ontario/Canada

      Patty! Isn't this just so amazing. 25-30 years ago these type of opportunities were only on TV shows. One of my favorite customers at my sewing shop (79 years old) walked around with two canes for the most part of 5 years before her children were able to persuade her to get her knees done. From what I gather very few surgeon will do both knees at the same time...they did with her. 3 weeks later she was walking, still with a cane (she came in for a fitting). 6 weeks after surgery she walked without cane. 6 months after she joined clogging dance classes.

      another great hub. regards Zsuzsy

    • profile image

      Cavyl 9 years ago

      Very useful information that can be used by anyone considering any type of surgery. Like you said the keys are patient education and doctor/patient relationship. Technology has certainly come a long way.

    • Patty Inglish, MS profile image

      Patty Inglish 9 years ago from North America

      Josh - Thanks, I hope people try that and have better knees because of it.

      Zsuzsy - What an amazing story! I am very happy for the woman with new knees.  The surgery here in the states has already been reduced in the time needed to perform it, and with alternative treatments, in 10 years we may have this problem pretty much liked - People will have choices other than surgery, but surgery will be easier, if research keeps presenting new improvements. 6 months to clogging - a miracle!

      Cavyl - thanks for visiting!  Technology certainly is amazing.    

    • Josh Tam profile image

      Josh Tam 9 years ago from Kch

      Patty, you are welcome. But FYI, sleeping during 10-12 is very hard for most people, cause they are always either too busy and have some night work to do at that time, or they wanna watch TV. It's like they always have something to do at night.

      I'm no exception, but I'm always trying my best to get everything done by 10pm. I'm only 20+ but I have to start worrying about my old days... :D

    • Patty Inglish, MS profile image

      Patty Inglish 9 years ago from North America

      Haha - That's smart thinking, though. You'll be healthier than most at 100! :)

    • Patty Inglish, MS profile image

      Patty Inglish 9 years ago from North America

      Thanks Decrescendo - I sprained both kees a the same time one summer and was imboilized for a dew days. I'd hate to have bad knees from arthritis and am fortunately not prone it Thank God. In a few years knee replacements will be much better and easier to take, so there is hope fo rknee suffers.

      Thanks for your post!

    • Clareo profile image

      Clareo 9 years ago from New Zealand

      Thanks for all your advice..what a great post. It is really helpful...I am nearly 40, and looking at severe OsteoArthritis in both knees...about to have my first surgeon appointment after the diagnostic is good to have a little information before I am faced with big decisions.God bless you all.Clare

    • Josh Tam profile image

      Josh Tam 9 years ago from Kch

      Clareo, be sure to get enough sleep... ;D

    • Patty Inglish, MS profile image

      Patty Inglish 9 years ago from North America

      Best wishes and prayer for you going up now, Clareo - my hopes are that very little, if any, surgey should be done. Nutritional supplements sometimes help as well. Best success to you! - let us know how it's progressing, please.


    • tinyteddy profile image

      tinyteddy 9 years ago from INDIA


      good to post this kind ofstuff here but i would prefer it to be much more authentic with due respects to you

      do you know that the treadmill itself causes arthritis?not all but certain ones unsuited to specifications

      each and every patient contributes to learning medicine. it is not that we fit what is readymade to suit the patients

      sadly nowdays medical equipment companies and pharma dictate to the doctors

      a lot of osteoarthtritis can be doneaway without knee replacement treatment

      but google ads may not be happy though it is good news to the patients themselves

      sorry if i had barged in but then i know you are a good hubber i only want you to be more responsible.

    • Patty Inglish, MS profile image

      Patty Inglish 9 years ago from North America

      I don't know what you're implying - I work with preventive medicine and alternative medicine contnually. I'm the one that gets people out of wheelchairs here.

      I've already stated in this article that some arthritis can indeed be reversed and prevented via diet, exercises, and other therapies. You must not have understood.

      Please add any other tips you have that will help others. Or we'd be pleased to read your own Hub on the subject as well.

      It is up to individual patients and those who seek prevention to work with their doctors and to read all they can about the subject, and Hub Pages is a step toward that increased knowledge.  

      As for treadmills - I don't like them for a variety of reasons.

      Thanks for the post.

    • Patty Inglish, MS profile image

      Patty Inglish 9 years ago from North America

      Couple of examples-

      A woman in her 20s came to me with rheumatoid arthritis and was told by her physician she'd be in a wheelchair in 12 months and dead in another year after that. Within 3 years, she was arthritis free, certified by her physician. Exercise, mental relaxation, and diet changes, along with herbal supplements she grew herself did it - plus prayer.

      A young teenager in middle school was a toe-walker, with knees that would not open more than half way. The family had reached its limit on physical therapy and treatment by insurance. Within a little over 2 years with my program, he was compeltly cured of all joint problems and was playing on his high school football and basketball teams. Not only that, he was taken out of special education classes and mainstreamed. He graduated from college when school and doctors said he would not even be able to get in. The family saved $60,000 by not submitting him to surgery in the mid 1990s.

      Surgery to me is always the last resort.

      Thanks for reading, Everyone!

    • Clareo profile image

      Clareo 8 years ago from New Zealand

      Hi allI requested this hub 3 months ago...and I wanted to follow up with what happened. I fired my surgeon, took my notes and MRI results and went to a Professor of Surgery who specialised in knees and hips.His advice was:1 Stay away from surgeons2 While sitting down, bring your leg up to parallel, and lower from the knee just a little (before any creaks or grating occur - hard as I had very gratey knees), and repeat, holding it 10 seconds each time, and repeating 10 times. This was to focus and strengthen my thigh muscles.3 Add a weight to your ankles (I bought 1.5KG ankle weights), and do this RELIGIOUSLY 3 times a day...which I did and have now been able to stop without ill effect...although he said to make it a lifetime routine...I still do now and then.He GUARANTEED that I would experience 75% improvement in my knee, - I hadn't been able to walk to the corner (one house away from our home) without severe discomfort for 6 months - and was very worried about having surgery at 40 years of age. I have three young kids and wanted to be active again and enjoy them.Within a WEEK of this religious routine, I had experienced 75% improvement - and now barely notice my knees at ALL! It is nothing short of a miracle for me.I scooter or ride my bike to school with the kids each morning - or occasionally even walk the kilometre each way!!!!!!!!!!!!!Thank you God for the healing - and thank you for all your helpful advice and information which was awesome. It was really appreciated that you cared enough to share with me your expertise Patty.I have started to hub now about how much Glen (my husband) and I are enjoying the children - inspired by you all participating in this hub too! Check out Daddy's Diary (Glen is the better writer by far - so he is the author).God bless and thank you all.

    • Patty Inglish, MS profile image

      Patty Inglish 8 years ago from North America

      Sincere congratulations!!! I'm your fan for life!

      Dancing for joy --


    • Patty Inglish, MS profile image

      Patty Inglish 8 years ago from North America


      SALT LAKE CITY (UPI) -- The supplements glucosamine and chondroitin sulfate perform no better than placebos in slowing the rate of cartilage loss in the knees, U.S. researchers say. University of Utah researchers said their ancillary study was conducted concurrently on a subset of patients enrolled in a larger trial The primary objective of this ancillary study was to investigate whether the dietary supplements could diminish the structural damage of osteoarthritis. The study, published in the October issue of Arthritis & Rheumatism, found none of the agents had a clinically significant effect on slowing the rate of joint space width loss -- the distance between the ends of joint bones as shown by X-ray. However, the researchers observed that all the study's participants had a slower rate of joint space width loss than expected, making it more difficult to detect the effects of the dietary supplements and other agents used in the study. "At two years, no treatment achieved what was predefined to be a clinically important reduction in joint space width loss," Dr. Allen D. Sawitzke said in a statement. "While we found a trend toward improvement among those with moderate osteoarthritis of the knee in those taking glucosamine, we were not able to draw any definitive conclusions."

    • ProfoundPuns profile image

      ProfoundPuns 8 years ago from Maryland, USA

      My mother had knee replacement surgery over a year ago, and everything has gone wrong. I will be writing a Hub on her unique case, possibly later tonight or sometime this week. Do you think you could take a look at it (once it's written) and see if you have any suggestions for her?

    • Patty Inglish, MS profile image

      Patty Inglish 8 years ago from North America

      ProfoundPuns, I'd be happy to look at your Hub for you. I feel bad for your mother, so I hope something can be done.

    • ProfoundPuns profile image

      ProfoundPuns 8 years ago from Maryland, USA

      I've finally finished writing about my mom's knee. Let me know what you think. Thank you.

    • Patty Inglish, MS profile image

      Patty Inglish 8 years ago from North America

      I'll go read it right now...

    • profile image

      The Sports Physio 8 years ago

      Hi Patty,

      A useful "Did you know?" for your readers!Quadriceps muscle (at the front of the thigh) weakness is a risk factor in women for development of osteoarthritis, implying that knee strength training can prevent degenerative knee joint disease.

      For those who have it already though, its not the easiest batch of exercises to undertake because of the need to load the knee joint. Still - if sleep before 12 is a key, so too is preventative strength training.

      Keep well.

      Reference: Bennell, K., & Hinman, R. (2005). Exercise as a treatment for osteoarthritis. Curr Opin Rheumatol, 17(5), 634-640.

    • Patty Inglish, MS profile image

      Patty Inglish 8 years ago from North America

      Sports Physio! _ Thanks for alerting readers about all of this remarkable information. My first Korean martial arts instructor told us that leg and especially knee strength would ward off the effects of old age and he was correct. I can support your evidence by saying that after 26 years of the training, I have no sign of oestoarthritis, even after ankle surgery. I am so blessed by people like you and my instructor that give out such good information!

    • Netters profile image

      Netters 8 years ago from Land of Enchantment - NM

      Great information. My husband is considering knee replacement. The VA doctor told him there was nothing more they could do for his knee. Right now it's rubbing bone-on-bone. He got hurt while in the Marine Corps and had ACL Reconstruction in 1988. Over the years, he now has arthritis. We really don't know where to go from here. Probably get a second opinion from a civilian doctor. He's only 46 years old. Thank you for all this information.


    • Patty Inglish, MS profile image

      Patty Inglish 8 years ago from North America

      Get a least 1 second opinion, and consider getting 2 second opinions - call teh medical bureau and ask for a list of doctros to see, Ask these doctors that you choose if artificial cartlage can be implanted or if the arthritis has prevented that. I would look for younger doctors that are more likely to work with patients and not give up. Best wiahes to you both.

    • Lgali profile image

      Lgali 8 years ago

      very good article

    • profile image

      John 8 years ago

      Great article. I sent it to my Aunt and highly recommend that she read it...

    • anitariley65 profile image

      anitariley65 8 years ago from Little Town Ohio

      This is awesome Patty. I have had bad knees for over 10 years. I had been getting cortisone shots in both of them until I got MRSA in the right one. I ended up having 2 arthro's in one week to clean out the infection. That was almost 4 years ago and that same knee is still doing great. I have osteoarthritis throughout my body, but when they cleaned up that knee it sure made a difference. I hesitate greatly at the thought of getting another shot in the other knee. Cortisone sure puts on the weight. And the added weight just makes the knees and hips worse. The advice about finding younger Dr.s is great. My PCP always sends me to OSU here in Ohio because they are finding new things every day for everything. Keep up the great work. Some people just don't know what options are out there.

    • Patty Inglish, MS profile image

      Patty Inglish 8 years ago from North America

      anitariley65! - yes, keep going to OSU. They've made great strides in knee health. Cortisone sounds dangerous.

    • franciaonline profile image

      franciaonline 8 years ago from Philippines

      Very informative hub! Thanks.

    • Win2Win profile image

      Win2Win 7 years ago from Wales

      Thanks for the article, I'm heading towards knee replacement, but hopefully I can keep what I have managed for as long as possible.

      I've already had a total jaw replacement for over 7 years now and had no problems with that, although the post-op care was pants with 3 cock-ups by the staff.

    • profile image

      Carol Foster 7 years ago

      Re: the woman who put on 4 inch heels after the surgery. Since a good built in arch support is important, I'd like to know what brand of shoe that was. Seriously, I've never seen a shoe with good built in arch support and I've seen a lot of shoes in my decades. If someone needs arch supports, shoes aren't going to have them. Any comment?

    • Pollyannalana profile image

      Pollyannalana 7 years ago from US

      Great Info and I know I will have to come back and study more thoroughly, great info I can certainly use.

    • profile image

      AG 7 years ago

      What is MRSA ? I am searching possible treatment for my mother's knee problem. She is in her late 60's. I even remember her suffering from leg pain when I was little. Now her knees are painful severely and stiff. She can barely walk. She lives in India. I just sent her Flexin (Glucosamin & chond supplement) along with ca supplement. That's all I could do for now. Any other suggestion...

    • profile image

      brtaiwo 7 years ago

      I have an old woman suffering such pain. I hope this works for her.

    • profile image

      alice 7 years ago

      I've got pretty nasty osteoarthritis, worse in one knee than the other and use a brace, which helps a lot to keep the bone ends from rubbing. Lately I haven't been able to use the brace because it bothers my circulation so I got myself a folding cane and when I get that "Igor" thing where I can barely lift my legs I can use two canes. So far it's been great and I can really clip along so fast I get out of breath so it's going to help me get more out of my walking exercise so I can lose a bunch of weight. I go to the pool and do a lot of exercise there where it feels so nice to not have all that weight on my knees. I go to sleep pretty early, get up early, and rest quite well. I'm kind of avoiding knee replacements until the technology gets a whole lot better and of course until I manage to lose about 100 pounds. Fingers crossed!

    • Patty Inglish, MS profile image

      Patty Inglish 7 years ago from North America

      Be encouraged for that weight loss. I've seen replacements not work because they were done for folks that were more than that amount overweight. Sounds like you're fending well and using your surroundings and equipment to your benefit, alice. Best wishes to you.

    • Gigi2 profile image

      Gigi2 7 years ago from UK

      Great hub, which I read with great interest as I am about to have a partial knee repacement, see my hub - Doubt. Great advice and research, thanks, thumbs up.

    • quuenieproac profile image

      quuenieproac 6 years ago from Malaysia

      I go for acupuncture at our Malaysian hospital where we have excellent acupuncturists from China, the relief from the knee pain is fantastic! They also prescribe herbal medicine but I am wary of the side effects so I do not take them . I also go for regular reflexology for soothing massages. I take glucosamine , need to go on a strict diet to reduce the pressure on my legs and have to exercise more to strengthen my legs. Eventually if my situation worsens I may need shots or knee replacement surgery. Meanwhile I pray and thank God for pain free knees with these short term measures.

      Thanks for the info in your hub.

    • profile image

      Jenny 6 years ago

      Do everything possible before getting a knee replacement. Believe me!

    • profile image

      Nadia 5 years ago

      My mother is 63 years old. She has osteo-arthritis. She started Glucasamine almost 1 ans half year ago. Until a year ago she could go for long walks in the park. Since then she had to be very careful as her knees especially her left knee starts to ache. We have been getting couple of mixed reviews from the doctors regarding her treatment. While the doctors have been saying that her knee isn't in that bad of a shape yet to require a knee replacement surgery, her walking is very limited and she has to be extremely careful (like no shopping or climbing stairs) or she starts to experience pain. The doctors suggested for synvisc injections or even stem cell treatment. Would greatly appreciate any guidance and referral for good doctors/centres for consultation in Malaysia. I lost my father earlier this year and so am very anxious to help my mum get the right treatment.

    • Patty Inglish, MS profile image

      Patty Inglish 5 years ago from North America

      I don't have access to Malaysian directories of phsycian specialists, but I hope that readers will see this and offer some names.

      Stem cell treatment, using the patient's own cells, is becoming more widely used for a variety of conditions and may hold hope for the knees as well.

    • profile image

      debbie 5 years ago

      am 46 have told carnt have knee replacement inconcent pain they have dischargme

    • profile image

      judyo 5 years ago

      I have osteoarthritis and I have bone on bone on one half of my knee. Should I get a partial knee replacement or a total one. Doc mentioned a total one. I am 65 and overweight as haven't been able to do exercise or walk much. What do you all think and what device is best.

    • profile image

      Anna 5 years ago

      I think you should strengthen your quads . Leg raises 5 second hold, tighten quad thigh muscles & relax do ten on each leg. Then sit level with your leg straight in front of you and pull back the knee cap using your quad muscle hold for 5 seconds then let go do as many as possible. If you do 100 that's fantastic strength your giving, after a couple of weeks you'll be surprised at your walking ability. Sorry on magic potions yet but I'm working on it, trust me, miracles come once every 100 years I believe.

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