The pros and cons of knee replacements

DEAR SAVVY SENIOR: My arthritic knee is killing me most of the time and my family doctor thinks it may be time for a new one. I understand there's a new total knee replacement procedure that provides a much faster recovery. What can you tell me about this? - Suffering at 60

DEAR SUFFERING

It's called the minimally invasive knee replacement procedure and while it does offer a faster recovery than the traditional method, it has its risks and it doesn't work for everyone. Here's what you should know.

Nearly half a million Americans - including the growing number of exercise-loving boomers - have knee replacements each year. But what's the best way to get them? Most people have the time-tested traditional surgery that requires a deep incision into tendons and muscle. However there are a growing number of people opting for the newer, less invasive method. Here are the pros and cons of each procedure...

...With minimally invasive surgery (MIS), surgeons make an incision only 3 to 5 inches long to remove the damaged joint and install the implant. Muscles are pulled aside rather than cut - which is the key - so there tends to be less pain, a faster recovery and a shorter hospital stay. Most patients, after an MIS procedure, take steps the very next day using only a cane. They spend only two or three days in the hospital and are walking without any assistance in a few weeks. The main drawback to this method however, is that the smaller cut (3 to 5 inches) offers less room to work, creating a greater risk of misaligning the knee, which can cause pain as well as wear and tear on the device. It's also important to know that the MIS technique is not for everyone. If you're overweight, or you've already had a replacement or extensive knee surgery you'll need the traditional procedure.

Points to consider

Before you decide to have any type of knee replacement surgery, here are some helpful points to consider:

- Is it really necessary? Surgery should be a last resort, if other treatments such as knee supports, exercise, weight loss and ultrasound fail.

- Look for experience: No matter which procedure you choose, look for an experienced, reputable orthopedic surgeon and a hospital that does a high volume of total knee replacements. The American Association of Orthopaedic Surgeons (www.aaos.org) offers a list of board-certified doctors to help you search in your area. Also, because the MIS technique is relatively new, less than 20 percent of the nation's 20,000 orthopedic surgeons do the procedure.