Replacement Knees – 5 Predictors of Future Wear & Tear

​The majority of people who have joint replacements have a knee that has developed a significant amount of wear and tear to the point where walking is excruciating. The cartilage (meniscus) of the knee has all but disintegrated or torn apart and they’re walking around with bone on bone.
 
 
In 2015 103,331 people in England & Wales had knee procedures according to the National Joint Registry. Thankfully knee degeneration is not an inevitable factor of aging, otherwise every single person would need new knees at a specific age, which is clearly not the case.
 
So what determines whether you will need new knees in the future and is there anything you can do to possibly avoid it?! This is something I have given a lot of thought to, particularly since learning about ABC.  A few years back my good Chiropractor friend, Amy and I would have light-hearted joking conversations saying ‘I ought to book myself in for a new right knee now!’ whilst having a moan about the aches and twinges in our joints. In the back of my mind I was starting to believe it, but not now-a-days.
 
My Dad (Poor chap, I’ve been using him in many of my examples), in his early 60’s, had two state-of–the-art replacement knees, specifically modelled for him and made in America. Like so many people he puts the degeneration down to years of playing squash and his active lifestyle. I’m sure he’s right however what ABC and the research done on Adult Tethered Cord Syndrome has taught us is that there’s more to it than just the hard work they’ve done.
 
His first replacement didn’t give him the immediate relief he was hoping for and has taken a good two years to feel better. The other knee felt great within a couple of weeks.
Why do you think they felt so different?
Around 6 months later he had a very bad episode of low back pain and sciatica. He was sent for an MRI scan which showed significant degenerative joint & disc disease in his lumbar spine. I thought it appropriate to mention this because so many people think that it’s just the knee(s) that have worn out and nothing else because nothing else hurts. This is so far from the truth. Osteoarthritis (aka wear and tear) of the lower limb joints will almost always be secondary to abnormal biomechanics in the spine and where there’s abnormal movement there ensues wear and tear.
 
Can you tell whether you will need new knees in the future? Based on my clinic experience of treating people who…a) have already had new knees fitted, b) those that about to have the surgery, c) those that describe moderate knee symptoms and fully expect to have to have surgery and d) young people whom do not currently have knee pain but show signs of musculo-skeletal dysfunction…

​My answer is yes, here are 5 predictors…

​If you have or have had…

1. Direct knee injury – Dislocation of the knee or patella (knee cap) and fractures particularly thought the joint line. As soon as you break a bone anywhere in your body you change the biomechanics of the whole body because of the knock on effect it has through the entire musculoskeletal system.

1. Early warning signs – Twinges and/or clicking knees. If the knee joint is aligned and working correctly it makes sense that it’s movement ought to be smooth and silent. Common knee complaints include clicking in the mornings or with bending and pain and stiffness or twinges walking up or downstairs. These symptoms may not be consistent either.

1. Asymmetry of the spine. Many of us have lost the normal curvature of the spine through injury or prolonged, repetitive forward or sitting postures. You can appreciate that as soon as the centre of gravity of your body shifts there will be uneven wear through the hips, knees, ankles and feet joints. Uneven wearing = arthritis.

1. Altered lower limb posture. Our fellow ABC practitioner, Jeff Aberle explains the relationship between the hip, knee and ankle joints and their posture or stance. Many of us, when standing tend to turn out one foot – that’s where it naturally wants to rest without us being consciously aware of it. To check yourself march on the spot looking ahead of you for 10 steps, stop and look down at your feet to see where they naturally came to rest. Another way to check is to lye on the floor with completely relaxed legs and feet and ask someone to notice whether your feet flop outwards evenly or not.

1. A poor squat movement pattern. If you watch a toddler they (mostly) squat perfectly, their back is straight, knees and hips are wide and they could play in that position for ages. We see a lot of poor squat motion patterns in adults. This is largely of restricted range of motion of their hips, knees and ankles. They can’t keep their feet flat on the floor and so raise onto the balls of their feet which places enormous strain on the knee joints. If you are in a position to start strengthening your knees and body I recommend you contact my personal trainer friend, Dave Wall, he's your best bet for a great quality, well considered workouts.

 
 
So the next time you hear someone say
 ‘Oh it’s just my knee, it’s nothing to do with my back’
           
You’ll know that it’s everything to do with their back and you know someone who can help… that’s me by the way!
 
If you know anyone who is suffering with their knees do refer them to me, I do love the challenge of potentially helping someone to avoid going under the knife.