5 Ways to Avoid Knee Replacement Surgery

Yesterday I mentioned that I would give you five ways to avoid knee replacement surgery.  With a cost that can run to $45,000, avoiding this expensive procedure can help both your health as well as your pocketbook.  That said, nothing is guaranteed and, if I was experiencing knee pain, I would strongly consider going to the doctor rather than listening to some blogger.  In other words, I am not a doctor, I don't play one on TV and I didn't stay at Holiday Inn Express.  These 5 ways to avoid knee replacement surgery are a preventative guide that is not intended to replace the doctor of your or the governments' choosing. Tip #1 - Get Up and Move, Everybody!

The first way to help your knees and avoid knee replacement surgery is to actually work with them.  Walk, hike, run, rollerblade.  Healthy activity will strengthen the muscles surrounding the knee and keep all the soft tissues - ligaments, tendons, cartilage - well lubricated and well supplied with blood which increase the rate of nutrient uptake and releases waste products more quickly.  The key is regular but moderate activity.  Be careful to avoid overdoing it.  I warn beginning runners that there are three primary reasons for injuries; too much distance; too much speed work; and, too much stretching.  Exercise but exercise moderation too.

Tip #2 -My Those Carrots Look Tasty!

The second way to avoid knee surgery is to take a close look at your eating habits and your weight.  I know, you're tired of the media, the government and the medical system harping on American's weight and the obesity epidemic.  But I am not talking to everybody else.  Just to you.  And I'm not telling you that you "have to" change your diet.  You're a big boy or girl and you can make up your own mind.  I have gout and I know that I should not drink beer but I do anyway because I like beer.  I don't do it often - pain is a great teacher - but I live with the consequences of my actions.  As you do.

So, think about making small changes to your diet.  I tend to favor a more natural diet high in olive oils and vegetables, moderate in meat, low in grains.  Why?  Because this works for me.  What I avoid is sugar.  All the available evidence indicates that sugar - specifically fructose (here is the definitive book on the subject) - is a major player in the obesity and diabetes problem of this country.  Wheat may be a close second.

Think about changes that you could make and stick with.  Start small and celebrate the successes.  They're your knees - and heart, lungs, etc.

Tip #3 -Remember Saturday Night Live?  Me Neither!

They used to used to run skit that always ended with "take a pill!"  Generally not the best advice but applicable here.  The National Institutes of Health is funding a study to see whether the combination of glucosamine and chondroitin helps repair cartilage. Let's quote the findings, "For a subset of participants with moderate-to-severe pain, glucosamine combined with chondroitin sulfate provided statistically significant pain relief compared with placebo—about 79 percent had a 20 percent or greater reduction..."

If you are already experiencing pain, consider these nutritional supplements.  If you are not, I don't know that they will help.

Tip #4 -Don't Step on My Blue Suede Shoes!

What you wear on your feet can greatly impact your knees.  Nurses have known this for generations as have beat cops (when we still had beat cops) and mailmen.  Quality footwear that provides proper support and cushioning is important to avoiding knee replacement surgery since the goal is to avoid damaging the knees in the first place. Athletic shoes are a good choice.  I like running shoes since I'm a runner but my wife likes a good quality walking shoe.

If you are exercising, especially running, you also need to have shoes that will control lateral or sideways motion of the foot.  This motion, called pronation, is natural but due to years of abusing their feet, many people have excessive pronation.  This can destabilize the knee joint.  Make sure the athletic shoes are fitted by someone that knows what they are doing.

Lastly, avoid high heels as much as possible.  That applies to you too, guys!

Tip #5 -Hey Doc!  It Hurts When I Do This....

If you do start having twinges in your knee, don't be John Wayne.  Get some professional help.  Knee pain tends to grow from a small to large chronic condition in the older adult population.  Most of us are not going to blow out a knee dunking the basketball.  Listen to your body and to your doctor.  The doctor will have a lot more therapy options - steriod shots, botox, electrical stimulation - that you can't do on your own.  Let them help.

___________ So that's the 5 ways to avoid knee replacement surgery.  No single huge do-this-you'll-never-be-broken-again.  Just some common sense advice.  I hope it helps.

Have a truly wonderful day!

Knee Replacement Surgery Numbers Soar Says JAMA

Knee replacement surgery numbers soar, according to a new study published by the Journal of the American Medical Association.  According to the study, from 1991 to 2010, the incidence of knee replacement surgery increased 161 percent.  This increase seems to be driven by the increase in Medicare patients, which makes sense as the population is aging and seniors are living longer.  Also a factor is a higher usage rate by the general population driven by the exercise industry - more on that below. More worrisome to me is the re-admittance rates to hospitals has increased while the recovery time in hospitals has declined.   Are we sending people home too soon only to have to re-admit them when the complications show up?

Knee replacement surgery, known in the medical field as a total knee arthroplasty or TKA, involves removing the existing weight bearing surfaces of the knee joint to relieve the pain from osteoarthritis in our older population.  In the general population, knee replacement surgery may be performed in response to meniscus tears, cartilage defects, and ligament tears that may cause enough pain to necessitate the surgery.

This is important.  In a time where every element of health care is under debate, a surgery that costs $10,000 to $45,000 whose growth is exploding makes it more likely that the procedure will face limitations not due to its effectiveness but for financial reasons.

One quibble that I have with the Yahoo! News article on the knee replacement surgery study is their statement "Knee joints wear out over time and use; the more physically active a person is -- depending on the type of activity -- the more chances are that one or both knees will develop problems."  While this is part of the conventional wisdom, a study from the J.B. Snow Biomechanics Laboratory at Wake Forest University in November 2008  states "Epidemiologic studies indicate that running reduces the threat of some chronic diseases, decreases disability and pain, and lowers healthcare costs." The problem is not the exercise.  The problem more often is total body weight, a sedentary lifestyle to allows the musculoskeletal system to weaken and poor technique during activities. 

Tomorrow I'll put together a post on some things that you can do to avoid knee replacement surgery.

Reversing Aging? Scientists are getting closer.

Reversing aging?  Appearently scientists are getting ever closer to the foundation of youth. They may have found a way to reverse the aging process in muscles - if it works, I'll be able to open jars again without resorting to cheap tricks or modestly expensive kitchens tools. Researchers have found a key protein that affects the way the body recovers strength and flexibility.  When injected into mice, the scientists limited loss of muscle mass and agility.  The hope is that the treatment will eventually be transferable to humans.

h/t Instapundit