Nightly News   |  August 01, 2013

What to know when considering knee replacement

Total knee replacement surgery is often a last resort for those whose cartilage has worn down, but doctors caution surgery alone is not the sole solution. NBC’s Dr. Nancy Snyderman reports.

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This content comes from Closed Captioning that was broadcast along with this program.

>>> our health segment tonight aimed right at the heart of the american generation with a mileage problem. too many miles on existing parts. like bad knees. and the need for replacement parts after realizing chronic pain is no way to live. as our chief medical editor dr. nancy snyderman reports tonight, sooner or later just about all of us may be facing this choice. and by the way, if starting in a few days time you don't see me around here for a while this is the reason why.

>> reporter: it is an operation some 650,000 americans will have this year. nearly double the number from ten years ago. total knee replacement surgery the last resort for men and women many babyboomers who have pushed themselves to the point where the cartilage in the knee has worn down. resulting in bone on bone contact and often excruciating pain. brian was playing high school football when he was side lined by a violent injury. that is him, number 89 , offensive end . you are a private person. we are talking about an operation. why?

>> i took a helmet to the knee in high school . it reversed my knee. they don't recommend that. i have been in pain for 35 years. i loved playing a team sport , i loved every minute of football. i have paid a very high price for what's been confirmed to be the single worst new jersey high school catholic league football career in history.

>> are you ever not in pain?

>> no. it is now costing me sleep. i reached a point recently in the last 12 months where i decided this has to happen. so, worst case scenario , if this doesn't go perfectly well, which it will, it can't hurt more than it hurts now.

>> reporter: that type of agony doctors say is the turning point for so many people deciding to have total knee replacement surgery .

>> he has a very enflamed knee.

>> when they get to a point where their quality of life in their estimation is limited then they come.

>> reporter: 54-year-old thomas apple injured his knee playing high school sports . and these days, while he can still shoot hoops with his son, stairs and driving are increasingly a challenge. his wife linda says their social life has also suffered.

>> we can't do the physical things people do on vacation in terms of let's say hiking and exercise.

>> living on borrowed time . it is hurting more and more. time to get it fixed.

>> reporter: while both tom and brian have had procedures to alleviate the pain, doctors caution this surgery alone is not a solution. here is a look at what any one thinking about knee replacement should kid. the surgery takes an hour and a half with a hospital stay of three days. following that, patients must do knee strengthening exercises several times a day to restore mobility. you will be using a walker or crutches. next plan on missing anywhere from three weeks to three months of work depending on how physically demanding your job is. after six months to a year, most people will be fully recovered and can resume all activities. two of the big secrets to the success for this surgery, one, being ready for it. being a good qualified patient. and second thing is really sticking to the rehab afterwards. those exercises make the difference between people who do just okay with the implant and those frankly who come out on the back end, brian , and say they have never felt better. i expect that to be you.

>> couple points. this is my fourth knee operation. i expect this one to be the charm. i basically wanted folks to know if i disappear for a while, where i am.

>> let me show you and folks.

>> i can't thank you enough for bringing this.

>> no problem. this is your femur and lower leg. this area where brian has run out of space. this plastic part its the normal cartilage. in your case, it is gone. you have bone pushing down on bone. after this is opened you well have a titanium plate, plastic cartilage, composite, then the neap is going to work like this. and you should have not only normal mobility and normal stability and no pain.

>> i am very mindful of what this is not. not cancer, not a bypass. not so many health challenges so many folks face. eventually i will too. it is still really elective surgery . so anxious to get it done.

>> if you are now joining the 650,000 other people who will have this surgery, the technology is good enough for you to do it now.

>> thanks so much for bringing my little friend. dr. nancy