As you might tell by our web-site, we’re not big believers in what we call knee joint amputation with insertion of an artificial prosthesis (a.k.a. knee replacement), but instead favor a knee replacement alternative. This is due to the big potential complications that come with knee replacement surgery as well as the possible long-term issues now just being observed. For example, there’s at least one large epidemiologic study that associates knee or hip replacement with higher rates of cancer and problems with the wear particles created by knee prostheses have been highlighted over these past two years. However, if you’re planning on going this route, what things are associated with needing a knee replacement or it’s alternative? A recent large study out of Virginia used data collected from the Osteoarthritis Initiative to see which of the almost 5,000 patients being tracked was more likely to need a knee replacement. What did they find? After adjusting for known prognostic factors, several previously unidentified predictors of future knee replacement were found including past history of knee surgery (RR=2.04, 95% CI=1.33, 3.13), knee flexion contracture (the inability to straighten the knee fully-RR=1.06, 95% CI=1.02, 1.11) and pain with bending the knee (RR=1.58, 95% CI=1.04, 2.39). The upshot? Try every knee replacement alternative you can such as physical therapy, hyaluronic acid shots, platelet rich plasma, or stem cells. However, if you find yourself still needing to undergo invasive knee replacement surgery, the metrics above may help you decide when to pull the trigger.