Orthopedic surgeon offers critical insights on total knee replacement surgery

In 2010, Bonnie Egbert, a veteran of more than 20 marathons, had to quit running due to excruciating pain caused by her right knee joint rubbing bone on bone.

"After running, my knee would swell, and I would have trouble bending," said Egbert. "Eventually, I couldn't stand up from a chair and put weight on my right leg without losing my breath from the intensity of the pain."

Egbert decided it was time to get total knee replacement. Nearly 600,000 knee replacements are performed each year in the United States, and an aging population is only going to cause that number to increase. Stephen Incavo, M.D., a Houston Methodist orthopedic surgeon specializing in joint replacement surgery, says there are some tell-tale signs that you might need a knee replacement.

"The first symptom for many patients is pain or stiffness at night," Incavo said. "While many think it is a normal occurrence after spending a day on their feet, it is not. When knee pain begins to slowly decrease your activity level and quality of life, it might be time to consider a knee replacement."

In some cases of knee pain, Incavo says a physician may recommend trying non-surgical options, such as physical therapy or anti-inflammatory medicine, to provide relief. If the non-surgical treatment does not help, it is best to see an orthopedic surgeon as soon as possible.

"Some patients wait too long after non-surgical options stop helping to come back in," said Incavo. "My goal is to get each patient back to a happy, pain-free life, but they have to tell me when something isn't working for them."

Incavo advises patients considering a knee replacement to look for a surgeon who has done many cases with a high success rate to help ensure the procedure is done correctly the first time.

As a result of her first knee replacement with another surgeon, Egbert's knee was full of scar tissue. Incavo, who has researched ways to avoid instability and other failures with total knee replacements, explained to Egbert that knee replacements that are not implanted correctly can cause the new joint to not function properly and can lead to revision surgery.

"I wasn't big on going through a second knee replacement, but after nearly four years of misery, I had to take the chance," Egbert said. "And, I'm glad I did. While running poses too great a risk for me, I am walking pain free again. Dr. Incavo cleared me to walk the half-marathon in January at the Houston Marathon, so I'm looking forward to my first marathon in years."