Lecture Notes
Expectations for Knee Replacements – Dr Ian Davison

Is it true that a knee replacement only lasts for 10 years? Dr Ian Davison gave an excellent talk at the SMA March Medical Update, where he showed us convincingly that this expectation is false.

True expectations of knee replacements

It is a knee substitute, not a new knee. You will be able to walk with minimal / no pain, and do lots of other activities such as golf, bowls and swimming. You may be able to kneel. You will have to avoid rapid acceleration / deceleration. There are lots of different options for the surgeon to consider including total, unicompartmental, patellofemoral etc… (which Dr Davison did note are of great interest to orthopods and less interest to most GPs, but it was certainly entertaining to see what a huge array of fancy gadgets they have on offer).

Based on a massive national joint replacement registry, the current evidence is that there is about an 8% chance of re-operation within 16 years of having a total knee replacement. We are even better at the local Nowra Private hospital, where it is about 6%. There is a higher risk of needing a revision if you have a unicompartmental or patellofemoral replacement, but they have other advantages that make them suitable for some patients.

False expectations

  • The knee replacement only lasts 10 years
  • You will be able to squat on your haunches

Tips

  • Remember to examine the hip, as hip pathology can present as knee pain
  • Request weight bearing xrays where possible
  • Consider surgical referral if there is a large functional impact and it has failed conservative management
  • Age alone is not a barrier to knee replacement

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