Anyone suffering from chronic knee pain knows that it’s no fun. While knee pain is a common complaint, chronic knee pain can make it difficult to walk and function in everyday life.



Osteoarthritis – a common cause of knee pain


So, what causes knee pain? A common culprit is osteoarthritis, a degenerative musculoskeletal condition accompanied by inflammation in the joints, which is one of the leading contributors of disability worldwide1. Osteoarthritis is caused by wear and tear of the cartilage that lines the bone of joints. While this tends to be more prevalent among seniors (explaining why we have national disability insurance schemes like CareShield Life – if you’re not sure what this is, here are the top CareShield Life questions answered), sporting injuries can also lead to premature osteoarthritis among those below age 50. This last point surprised me, as we always think of sports as beneficial for health, but sometimes, it can lead to health problems too.


Depending on your unique situation and degree of pain, knee replacement surgery may be an option. But how do you know when it might be the right time for you?


Dr Gurpal Singh, orthopaedic surgeon at the Centre for Orthopaedics and Hip and Knee Surgery, sheds light on this procedure that's increasingly common among young people.


He also outlines the key considerations for knee replacement surgery as a treatment option for chronic knee pain due to advanced osteoarthritis.



Treatment options for osteoarthritis


According to Dr Singh, who has treated patients with osteoarthritis for more than 15 years, there are various treatment options to consider. Doctors usually recommend conservative or non-surgical pain management measures before knee replacement. For instance, physiotherapy and medication will typically be explored before resorting to surgery.

Majority of the knee replacement surgeries Dr Singh performs are a result of osteoarthritis.


So, when is the right time for a knee replacement?


When non-surgical methods don’t deliver the desired outcome – and only after detailed analysis of the patient’s condition and medical history has been explored – an orthopaedic surgeon may recommend joint replacement.



Why are more people, especially the young, turning to knee replacement surgery?


There are several reasons why more people, especially the young, are turning to knee replacement surgery for osteoarthritis.


It’s reliable

Patients with end-stage osteoarthritis can go on to lead an independent life.


•  Patients can stay active for longer

The notion of gradually losing the ability to do daily activities due to joint pain is no longer an accepted part of ageing, as many want to remain active in their 60s, 70s and beyond. On the note of ageing well, check out this piece on the path to a long and happy life.


Advances in implant materials and surgical techniques

Patients have greater confidence in surgical intervention, especially those who not only want to reduce pain, but also return to sports.



How does knee replacement surgery help?


Knee replacement surgery is performed to relieve pain and restore function – usually after detailed diagnosis by an orthopaedic surgeon to rule out other causes of the pain and justify the surgery.


It should only be considered when:


  • Other options are no longer viable
  • The pain is affecting your daily life
  • Joint-preserving surgical procedures, like key-hole surgery (knee arthroscopy), are unlikely to help



Are there any risks and limitations?


Your orthopaedic surgeon will counsel you on your individual risk-benefit profile.


Blood clots, stroke, heart attack, nerve damage or infection

• These are some of the serious complications, but they’re rare.


New joint may not last patient’s lifetime

• Artificial knee joints may wear out over time. Joint registry data shows that more than 80% of total knee replacements last 25 years.2

• Robotic-assisted surgery may help ensure optimal positioning of the artificial knee, thus reducing the risk of accelerated wearing out due to mechanical malalignment of implant components.



What’s the recovery process like?


Every individual’s recovery will be different, but most patients regain functional mobility six weeks after surgery. Some patients even resume light sports three months after surgery.



Can arthritis be prevented in the first place?


While there’s no real cure for arthritis and no definite way to prevent this common chronic illness, you can still take charge of your life and reduce the odds of getting advanced arthritis or slow its progression by doing the following:


• Lead a healthy lifestyle and do low-impact exercises regularly

• Keep your weight in check, stop smoking, and get advice for infection or injury, which may damage joints


As Singaporeans continue to live longer and our window for developing chronic illnesses like arthritis widens, the best thing we can do is to lead active lives, watch our health and when necessary, seek medical attention early.


1. Source: World Health Organization, “Musculoskeletal Health”, published on 14 July 2022.  


2. Source: Vol 393, Issue 10172, P655-663, The Lancet, “How long does a knee replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up.”

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