Total knee replacement (TKR) surgery is an operation for the treatment of degenerative knee conditions– increasing TKRs are performed annually, after which most patients are relieved of their chronic pain and enjoy an improved quality of life.

A Malaysian consultant orthopaedic surgeon, Dr. Gandhi Nathan Solayar, does not believe age should be adeterrent. Dr. Solayar often sees patients with advanced arthritis of the knees and have failed conservative management – with painkillers and exercises – thus warranting a TKR. Some patients over 60 are especially afraid of undergoing surgery because of their age.

However, a large 2013 UK study of TKR in elderly patients aged 80 and above dispels apprehension: these patients do enjoy the benefits of pain relief and improvement of function – even up to 10 years following their surgery.

TKRs in older patients are usually performed under spinal or regional anaesthesia as it reduces potential cardiopulmonary problems with better pain control immediately after surgery. Exercise improves surgical outcomes and overall joint function, which the surgeon or physiotherapist will advise on.

But, older patients who undergo TKR and suffer common medical problems such as diabetes or hypertension will be referred to a physician beforehand to ensure that all pre-existing conditions are suitably addressed.

There are sensible, straightforward methods of improving the condition, such as:

• use of painkillers and joint injections;
• avoiding long walks up hills or running;
• weight loss to reduce stress on the knee joints; and
• targeted exercise to improve knee joint function.

If conservative methods fail or the arthritis is advanced, a TKR may then be the best option.