When is Knee Replacement Not a Good Idea?

Certain health problems may need to be addressed prior to elective total knee replacement to reduce the risk of serious complications. Some of these health problems are:

Uncontrolled diabetes with a blood test showing an elevated hemoglobin A1c can elevate the risk of postoperative infection and wound healing problems. In this case the patient may need diet, exercise, pills, or insulin injections to improve blood sugars to safer levels before surgery. Always better to optimize diabetic sugar control before proceeding with a total knee replacement and unnecessarily risking a devastating complication like infection.

Poor dentition with loose teeth, cavities, or gingivitis. In these cases, the patient is advised to complete all needed dental work before surgery. Invasive dental work after surgery may increase the risk of spreading bacteria from the mouth to the knee implant via the bloodstream and ultimately cause an infection.

Inadequate nutrition, which can slow down or prevent successful healing after surgery. The patient may benefit from nutrition consultation or caloric supplementation with protein shakes before surgery. We routinely provide a nutrient rich shake for patients to take in the days leading up to their surgery to maximize their potential for healing.

Lab work that shows irregularities. These irregularities can often be corrected. For example, an iron deficiency can often be corrected with iron supplementation. Chronic anemia can be uncovered and treated in some circumstances reducing the need for potential transfusion post-operatively.

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