FEMALE ANNOUNCER:
From NIHSeniorHealth.gov, built with you in mind. I could not walk
up and down steps. I could not use
my vacuum cleaner. I couldn’t do anything
because I had to have a brace and a cane on my leg. I was walking
with a total limp, pretty much
dragging my right leg because the pain
was so excruciating. Oh, a whole lot of pain. A whole lot of pain. I couldn’t even walk. MALE NARRATOR:
Pain, like the type described by these women,
is one of the main reasons people choose to have
knee replacement. The pain can be caused
by many things, but the main reason
is arthritis. Dr. Marc Rankin: This is
an example of an arthritic knee with asymmetrical narrowing
of the joint interval. You can see bone-on-bone articulation on the inside of the knee and you can also see
abnormal bone formation or what we call
osteophyte formation on the outside of the knee. NARRATOR: Dr. Marc Rankin,
an orthopedic surgeon who has performed
knee replacement surgery for more than 10 years,
looks at several criteria before recommending the surgery. I generally have
four criteria that I use for
knee replacement surgery and when I think
somebody is a candidate. And I base that on pain level, walking tolerance, walking aid,
and a subjective criteria, quality of life measure. Pain on a scale of
zero to ten, zero being no pain at all,
ten being the worst pain anyone’s ever experienced
in their life. If they put their knee pain on average at a seven
out of ten, that’s one indication. The second one
is a walking aid. If somebody needs a cane
or a brace to walk or a walker, that’s yet another indication. A third indication
is walking tolerance. If someone can’t walk
a block or two or stand for
about 20 minutes or walk for
about 20 minutes, that’s yet another indication. And the fourth one,
which is more subjective, is the quality of life measure. If that patient feels
that they can no longer perform those activities
of daily living without pain or those activities that brought
enjoyment to their life without pain,
that’s the fourth indication. So when three out of
those four criteria are met, that’s when I feel
somebody’s ready to undergo joint replacement surgery. NARRATOR:
Knee replacement generally works well
for older adults because their levels
of physical activity do not overly tax
the new joint. I believe surgery
is just as successful as people over the age of 65
as anyone else. As a matter of fact,
even more so. Those patients
tend to be individuals that live a relatively
sedentary lifestyle and their demands
on their joint are not as much as somebody
who’s younger and more active. Which means the life of
the component will last longer. They can last anywhere now
from upwards of 15-20 years. NARRATOR:
However, Dr. Rankin says that patients should have realistic expectations about their levels of activity after the surgery. Individuals who are – who are more active
and who are younger, less than 60, who think
that knee replacement surgery is going to allow them be
like the bionic man and run faster
and do more activities, those individuals,
in my experience, have not fared as well. And so, if somebody
has early arthritis and they feel that they’re
not able to perform at the level they were before
the arthritic process set in, and they feel
that a joint replacement is going to allow them
to return to that level, it generally does not. It’s not made for
that type of activity level. So the expectations
play a big part in the outcome with joint replacement surgery. NARRATOR: Since their recent
knee replacements, these patients
are mostly pain free and they’re
starting to resume many of their normal
activities. I’m able to climb stairs
in my house. I’m able to do my housework
and stuff again. I’m able to walk
down the streets. I am nowhere near in the pain that I was before my surgery. I have pain now,
but this is recovery pain. It’s nowhere near the pain
that I had prior to this. I’m not in any pain at all. The only problem I have
is like the stiffness in my leg. If I sit for any length of time,
it can get stiff on me. You can still have
some discomfort to some degree, even after having
knee replacement surgery. But certainly
it is to a level less than they were before having
undergone the procedure. The surgery has been
really helpful to me. And I’m glad
I did have it done. MALE ANNOUNCER:
To learn more about knee replacement
for older adults, visit
the knee replacement topic on the NIH Senior Health
website at www.nihseniorhealth.gov.