Case Study
Health advice: Knee replacement surgery
A health insurance member experienced the onset of moderate to severe knee pain following a twisting injury.
After a normal X-ray, their GP referred them to an orthopaedic surgeon, who ordered an MRI. The MRI showed moderate osteoarthritis affecting two compartments of the knee. The member was advised that the only treatment option was total knee replacement surgery. Despite receiving no non-operative treatment, their knee pain had improved by around 70%.
Through their health insurer’s member benefits program, the individual sought a second opinion. An independent orthopaedic surgeon with expertise in knee surgery advised that knee replacement surgery would be premature at this stage. They concluded that, with appropriate non-operative treatment, the member could reasonably expect further significant improvement in symptoms, making them more tolerable and less likely to have a substantial impact on quality of life.
The following non-operative strategies were recommended:
- Weight optimisation
- Physiotherapy
- GLA:D program (an evidence-based education and exercise program for individuals with symptomatic knee osteoarthritis)
- Consideration of intra-articular injections
- Regular paracetamol
- Use of a walking stick when ambulating
Outcome
The member was advised that, if their osteoarthritis progresses over time, knee replacement surgery may eventually be appropriate. However, if that becomes necessary, they should carefully consider the risks and benefits before proceeding.