When a person experiences chronic knee pain or reduced mobility that doesn’t improve with non-surgical treatments, a total knee replacement (TKR) may be considered. However, before making that decision, the surgeon conducts a thorough evaluation to determine if the patient is a suitable candidate for the procedure. This evaluation process includes a detailed diagnosis to ensure that TKR is the best treatment option. Here’s what a total Total Knee Replacement surgeon in Houston, Texas looks for during the diagnosis.
1. Patient History and Symptom Assessment
The diagnosis begins with a detailed patient history. The surgeon will ask about the patient’s medical background, including any previous knee injuries, surgeries, or conditions that might affect the knee, such as arthritis. The surgeon will inquire about the nature, duration, and intensity of the pain, as well as its impact on daily activities. For instance, they may ask whether the patient has difficulty walking, climbing stairs, or performing other basic tasks. The surgeon also looks for signs of instability, deformity, or stiffness in the knee.
It is important to understand how long the symptoms have been present and if any conservative treatments, such as physical therapy, medication, or injections, have been tried, and whether they provided any relief.
2. Physical Examination
The next step is a physical examination of the knee. The surgeon will carefully assess the knee’s range of motion, stability, alignment, and strength. This evaluation may involve checking the knee’s flexibility, the presence of swelling, and any signs of tenderness or warmth. The surgeon will manipulate the knee joint in different positions to determine the extent of pain and any signs of joint instability. A common test during this phase is the “McMurray Test,” which assesses the knee’s cartilage for any tears.
The surgeon will also assess for signs of deformity, such as bowing of the legs (varus deformity) or knock-knees (valgus deformity). The alignment of the knee is crucial for understanding the need for a replacement, as misalignment can cause uneven wear on the joint, leading to pain and dysfunction.
3. Imaging Studies
Imaging tests, such as X-rays, are essential in diagnosing the condition of the knee joint. The surgeon will use X-rays to assess the extent of joint degeneration, including the level of cartilage loss, bone spurs, and changes in joint space. In cases of advanced osteoarthritis or other degenerative conditions, X-rays will often show significant joint space narrowing and deformities.
In addition to X-rays, the surgeon may order an MRI (Magnetic Resonance Imaging) scan if there is a concern about soft tissue damage, such as ligament tears, cartilage injury, or meniscal damage. An MRI provides a clearer picture of the knee’s soft tissues, which can influence the surgeon’s decision regarding the type of surgery and the need for additional procedures.
4. Assessing the Impact on Quality of Life
Another critical aspect of the diagnosis is assessing how much the knee condition is affecting the patient’s quality of life. If the pain severely limits daily activities such as walking, standing, or exercising, and if these limitations are not alleviated by other treatments, surgery may be considered as a viable option. The surgeon will also evaluate the patient’s expectations from the surgery and discuss the potential outcomes, recovery time, and risks involved.
5. Overall Health and Suitability for Surgery
Before recommending surgery, the surgeon will consider the patient’s overall health and suitability for the procedure. Factors such as age, weight, underlying medical conditions (e.g., diabetes, heart disease), and lifestyle are important. Surgeons generally recommend knee replacement surgery for patients who are in good enough health to undergo the procedure and recover effectively. Those with significant health risks may be advised to pursue less invasive treatments.
A thorough diagnosis is critical in determining whether a total knee replacement is the right course of action. Through a combination of patient history, physical examination, imaging studies, and an assessment of the patient’s overall health and quality of life, the surgeon can make an informed decision on the best treatment plan. This careful, multi-step evaluation ensures that knee replacement surgery is only recommended when necessary and appropriate, providing the patient with the best chance for a successful outcome.