Delaying or Avoiding Knee Replacement Surgery

As physiotherapists, we are often asked how to avoid joint replacement surgery, especially knee replacements. Although surgical procedures are improving in functional outcomes and longevity, they often still leave patients underwhelmed by the result. Many find that they are restricted in sports and activities they previously enjoyed.

This blog provides information to better understand the processes occurring within the knee that leads to a degenerative or arthritic condition and strategies to help delay or avoid a joint replacement.

What happens in the knee joint for a replacement to be required?

• Articular cartilage covers joint surfaces and is a low friction and high shock absorbing tissue, which is important in joints like the knee.
• Trauma sustained to the cartilage may be caused by a single traumatic injury or can develop gradually overtime through repetitive loading of the joint.
• Cartilage has poor blood supply, which means damage does not heal adequately and begins a slow process of degeneration.

What can be done to avoid this?
A large portion of traumatic injuries are difficult to avoid due to the unpredictable nature of the environment in which they occur, such as a soccer game or skiing. However, the cause of gradual wear to the cartilage over a longer period primarily relates to the biomechanics at the knee joint.

What does this mean?

• Biomechanics relates to movement and the way in which muscles activate around the knee.
• Muscle imbalances occur when there are weak or tight muscles. An imbalance in the muscles surrounding the knee changes the way the joint moves and bears weight, which leads to uneven or incorrect loading of the cartilage surfaces in the joint.
• The knee does not experience loads in isolation, it is affected by the ankle and hip. Therefore, when assessing biomechanics, the whole lower limb, and sometimes the whole body, is assessed for altered movement patterns.
• These factors can be changed to reduce the amount of trauma sustained by the knee’s cartilage.

What can BeachLife Physiotherapy do to help?
Biomechnical Assessment - A thorough physiotherapy assessment will consider your individual biomechanics and what is causing these changes. This then allow us to provide you with an individualised treatment and exercise program.
Correct Muscle Tension - There are 4 major muscle groups acting at the knee. When they become tight, these muscles increase pressure within the joint. These are the gluteals, quadriceps, hamstrings and calf muscles. Stretching these muscle groups will relax and lengthen the muscle tissue and decrease tension at the joint.
Correct Muscular Weakness - The same muscle groups support the knee joint. The gluteal and deep hip stabilising muscles are important as these control stability and rotational movements at the knee, which has big implications for degeneration of knee cartilage. Adequate strength in all the surrounding muscle groups reduces the load on the joint and cartilage.
Correct Balance – Proprioception, or more simply ‘movement sense’ relates not to muscle strength but muscle coordination. It is the ability for muscles to activate and work together to maintain stability around a joint as you move.
Physiotherapy is most effective when used in conjunction with other lifestyle changes such as a regular routine of low impact exercise, maintaining a healthy weight and eating a nutritious diet.
 
It is important that you seek advice if you notice any change in function or pain in your knees. If you are concerned about or need advice on any of the above please do not hesitate to call us to book an appointment on 9970 7982, or alternatively book online at beachlifephysio.com.