How to Tell if Knee Surgery Is Needed or Not

There’s no argument that modern day surgery can be a wonderful thing; it can give people a new lease of independence, mobility and relief. However, its definitely not always the best path for most knee pain.

Today, we discuss the times when knee surgery is appropriate, and when you might be better off pursuing other treatments.

What Do We Mean By Knee Surgery?

In this article, when we use the term knee surgery, we are referring to the following operations:

An Arthroscopic Procedure: Usually described as a “clean-up” of the cartilage in the knee. Performed through a tiny opening called a “keyhole”. Useful for meniscal tears and small but troublesome areas of damage.
A Ligament Reconstruction: The process of repairing a torn ligament, usually performed through a keyhole. A very clever surgery that usually involves taking a strip of tissue from elsewhere in the leg and using that as a make-shift ligament. This is how a cruciate is repaired in footballers and other athletes.
A Total Knee Replacement: The biggest knee surgery you can undergo – involves a major procedure where your knee is opened up and the entire joint is replaced by a titanium or ceramic replacement joint. This operation is indicated when the cartilage within the knee has deteriorated so badly that it is beyond therapy or minor surgery.

While the total knee replacement is the most significant of all the common knee surgeries, none of these procedures are to be taken lightly and all should be treated with equal consideration.

What Injuries Can Lead to Knee Surgery?

There are a number of common injuries that sometimes need surgery to return a person to an acceptable level of activity.

It’s worth noting that there are no injuries (other than major trauma) that ALWAYS need surgery – I have personally known people who are able to play football despite never having a cruciate tear repaired.

However, there are certainly times when surgery should be considered – read on for some of the most common injuries that require some form of repair:

Knee Injuries that SOMETIMES Need Surgery

A Cruciate Tear: Ligaments such as the anterior cruciate ligament that have huge importance to the function of the knee may well need to be repaired if you are someone who is very keen on sports. However, a repair is not always necessary for people who don’t play a lot of sport. With a significant ligament tear, there isn’t often a great deal of pain after the first few months, although there may be some instability.
Meniscal Tear: The “footballers cartilage” is a type of cartilage in the knee that provides shock absorption and lubricates movement. With twisting movements, this structure can tear and cause “locking” of the knee or giving way. These injuries can remain painful for a long period of time but usually they DO get better on their own with a bit of therapy; however, some people prefer to get early surgery.
Advanced Knee Arthritis: Almost EVERYONE over the age of 50 will have some degree of knee arthritis going on, probably in both knees. Usually, this arthritis is pain-free but sometimes it can cause significant pain, swelling and stiffness. If this problem goes on for a while and keeps getting worse, a total knee replacement may be advised.

How to Decide Whether it’s Time for Surgery

The main takeaway from this section should be the following: This ISN’T a decision you should be expected to make on your own!

We usually recommend the following: You should, in almost every circumstance, try everything you possibly can before opting for surgery.

Why do we say this?

The risks of surgery should not be under-estimated. Surgery, no matter how minor, always carries significant risks.

Secondly, if you opt for early surgery, you are leaving yourself at risk of complications later down the line, including accelerated arthritis.

Surgery is definitely NOT the easy way out – there will be considerable pain and disability for a period of time after any surgery and the psychological trauma of going under the knife is NOT to be underestimated.

I have had clients who opted for surgery, only to find that the operation didn’t have the desired outcome and they actually ended up WORSE than before – along with all the trauma of the procedure itself.

But, again, this shouldn’t be seen as a “scare piece” on surgery! It can be absolutely fantastic – you just need to make sure it’s the RIGHT decision for your personal situation.

What to Try Before Considering Surgery

You can use the following list as a “checklist” for all the things you should probably try before turning to surgery:

A Serious Course of Physiotherapy: Getting knee physiotherapy from an expert with experiencing in helping people avoid surgery due to knee pain can hugely lower your chances of needing to go under the knife. Be sure to see an expert over the recommended number of sessions; often, not enough sessions are given on the NHS… leaving people at risk of needing early surgery.
Changing Your Usual Exercise: Quite often, people find that their walking is affected so much that they see no way forward other than surgery. However, changing that weekend walk for a weekend bike ride instead may improve the health of your knees and delay surgery by years. Consider switching from walking or running to cycling or swimming.
Getting Significantly Stronger: This comes along with getting tailored physiotherapy treatment – but the importance of strong knees should NOT be underestimated when it comes to delaying surgery! Plus, if you did still need to go under the knife, you’ll be in a much better position to recover afterwards if you have strong muscles to support the knees.
Getting the Range Back in Your Knees: With any significant knee pain or injury, a loss in range of motion occurs. This can actually cause more trouble than most people give it credit for. Losing range in your knees and other joints will affect the way you perform movements like going from sitting to standing. This can lead to worsening pain in the knees. By improving the range in your knees, you can often actually significantly bring your pain under control. For more advice on this, click here to talk to an expert physio over the phone and get some personalised instruction.
Use Hot and Cold Therapy: Alternating between hot and cold treatment on the affected knee can work wonders in reducing your joint pain and will increase the range of motion. For more instruction on the RIGHT way to use hot and cold therapy, try our FREE guidebook – 5 Expert Tips to Relieve Knee Pain that Causes Stiffness and Limits Walking.

What to Do Next

For more tips and techniques on how to beat knee pain at home and avoid risky surgery, download our FREE knee pain guidebook below – it will give you some key tips and tricks you can start using today to relieve that knee pain you are currently suffering with.

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Click HERE to Download Your FREE Knee Pain Guide Now!

Carole Bush

23/04/2023

Will is very approachable and yet professional. I had an extremely painful flare up of arthritis in my knee. I didn’t want to go to my GP for painkillers. After 7 sessions with Will my knee is back to normal which is amazing! I am so pleased and grateful. I would highly recommend Will.

Caroline Crolla

14/04/2023

Will was very helpful with my knee and hip pain. He listened carefully and then diagnosed and treated my pain effectively. I liked being given a limited number of exercises to work on at home. This combination now means that I am pain free which is great. I recommend Will wholeheartedly.

Evelyn Hole

11/04/2023

I really enjoy all the information gleaned from the e-mails I get, It helps to be more knowledgeable.

Caroline Bridger

03/02/2023

I had a pretty severe issue with Sciatica. Will helped to get me moving again so I could resume my day to day activities

Angela Parke

20/01/2023

Before my first appointment with Will at HT Physio, I had suffered with chronic lower back pain and stiffness for 5 years. At its worst, I was unable to walk for more than 5 minutes without sitting down. I used to be able to go for 10-15 mile walks, but this was no longer possible. I felt miserable and thought that I would never be able to do the things that I used to do. During those 5 years I had consultations with NHS physiotherapists, but, as the appointments were limited, I never saw the same physiotherapist from one appointment to the next, and I was given very little specific guidance, so they did not help the problem. In desperation, I had treatments from a chiropractor, but these only made my back pain worse. Fortunately, while searching the internet 2 years ago, I found details of HT Physio and subscribed to the Three-Tip Friday emails. Shortly afterwards, I booked my first appointment with Will. I was impressed with how detailed a history he took, how thorough his examination was, and how reassuring he was that my back problem could be improved. I left with a set of exercises to do at home. At each subsequent appointment, he checked whether there had been any improvement in my pain and stiffness and how I was finding the exercises, modifying or changing them if necessary. Along with ultrasound and massage treatments, my back problem gradually improved, and was fully resolved in 5 months. Last summer while I was in holiday I was back to walking 13-16 miles a day! I have continued to book appointments with Will when I have had other musculoskeletal problems and I now see him every few months to check that everything is still ok. I very much appreciate not only his excellent diagnostic skills, treatment and advice, but also the reassurance that he gives that any problems can be improved or resolved. I highly recommend Will at HT Physio.

Juliet Browne

20/10/2022

I saw Will a few days after I had injured my arm. He was brilliant. He identified the problem with my rotator cuff and following his course of my treatment and exercises I'm very glad to be back to normal! The environment is warm and friendly from the moment you are greeted by Bryony in reception.

john white

15/09/2022

After a number of sessions with Will I am know free of neck pain. Will took the time to listen to my problem and provided me with complete confidence in his approach to resolving the problem I had. He is extremely knowledgeable and I have no hesitation in recommending him to you. Whilst undergoing treatment I took the opportunity to read Will's book "Thriving Beyond Fifty"...an easy read that is packed with great advice on staying healthy, which again I would thoroughly recommend.

Rachel Thompson

After a poor experience with an NHS allocated Physio I contacted HT Physio for a consultation re my shoulder. I had broken my collarbone and had frozen shoulder. I was told by the other physio that I was looking at a 2-4 year recuperation and unlikely to get full movement back as I was over 50! One year on, 10 months with Will at HT Physio and I am back to my ballet fun class, movement fully restored and pain free. A kind, compassionate, great listener Will diagnosed what was needed, clearly explained exercises and demonstrated. Printed visuals and equipment needed were provided. Appointments were regular and my choice. Text/email notifications were great. Price acceptable and on hindsight underpriced for results achieved. My injury was treated throughout Covid times as the comfortable treatment room and waiting area was kept immaculately clean and hygienic. I 100 percent recommend that you use HT Physio in Farnham.

Gary Woolgar

18/07/2022

I came to HT Physio after 6 months of not being able to run with a damaged knee. After I had seen my doctor who sent me for NHS physio which didn't seem to be helping. When I met Will at HT physio he was the first person to diagnose it as a meniscus tear. And explained to me what I had done. Over the next week's he devised an exercise plan too slowly strengthen my knee and encourage the healing of the meniscus. He told me it would take about 3 months which it did. When I first saw him I could not take one step without pain now I am completely pain free and back running again. I was very impressed with his professionalism and all the help and advice he gave me, I would highly recommend him. Gary Woolgar.