Yes, it is highly recommended and common for those over 70 (they have the best results in this group).
Very few serious complications:
- Infection: <1%
- Clot: <1% (with prophylaxis)
- Prosthesis loosening: <5% in 15 years
Patient satisfaction in those over 70 is usually above 90%.
You can usually walk with crutches or a walker (full weight bearing) on the **same day or next day** of surgery.
- **Simple tear + repair (meniscus suture):** 1–3 days with crutches, then walk normally
- **Removal of part of the meniscus (partial meniscectomy):** Often the same day without crutches or with crutches for 1–3 days
90% of patients walk fully after 1–7 days.
1. **Rest + Ice** (15–20 minutes, several times a day)
2. **Anti-inflammatory drugs**:
- Ibuprofen, naproxen, celecoxib (as prescribed by a doctor)
- In severe cases: short-term oral corticosteroid
3. **Intra-articular injection**:
- Corticosteroid (fast and strong)
- Hyaluronic acid (viscosupplement)
- PRP (in special cases)
4. **Physiotherapy and quadriceps strengthening**
5. **Weight loss** (every 5 kg ≈ 20 kg less pressure on the knee)
6. **Knee brace or medical insole** (in case of deformity)
7. If inflammation is severe and persistent: arthroscopy, joint lavage or joint replacement
Yes, it is **completely useful and almost necessary**.
Short reasons:
- After knee replacement, **you should not bend your knee more than 90 degrees** for 6–12 weeks.
- The Iranian toilet causes excessive knee bending and pressure on the prosthesis → risk of dislocation or loosening of the prosthesis.
- The toilet + **toilet conversion (high seat or riser)** allows you to sit and stand comfortably without bending too much.
Recommendations from doctors and the Iranian and World Orthopedic Association:
- At least **the first 3 months only the toilet** (preferably with a high seat of 45–50 cm).
Knee replacement is **prohibited or very risky** in these people:
- Active infection in the body or knee (prohibited until complete treatment)
- Complete paralysis of the quadriceps muscle (cannot straighten the leg)
- Very severe peripheral vascular disease (the leg does not have enough blood supply, the wound does not heal)
- Open wound or skin infection around the knee
- Severe mental illness or uncooperative patient (such as advanced dementia)
- Very unstable cardiovascular disease (who cannot tolerate anesthesia)
- Severe obesity (BMI above 45–50) → Very high risk, some surgeons do not accept
In other cases (even over 85–90 years old or diabetes and controlled blood pressure) it is usually performed.
The most common causes are:
Long-term use of corticosteroids (most common in Iran – even 1–2 months of high doses)
Chronic and heavy alcohol consumption
Fracture or dislocation of the femoral neck (cut-off of blood supply)
Sickle cell anemia (sickle cell disease)
Repeated deep diving (divers' disease – nitrogen bubbles)
Lupus, rheumatic diseases + corticosteroids
No known cause (idiopathic – about 20–30%)
Summary: 70% of cases in Iran are due to corticosteroids or alcohol.
Most common:
Anterior cruciate ligament (ACL) tear – most common cause of “knee going” feeling
Old meniscus tear or injury (especially medial meniscus)
Laxity or tear of lateral collateral ligaments (MCL/LCL)
Severe quadriceps weakness (post-surgery or prolonged immobilization)
Cartilage damage or advanced osteoarthritis (stage 3–4)
Short and practical treatment:
If ACL torn → ACL reconstruction surgery (best and most definitive)
Injured meniscus → Arthroscopy + repair or removal of torn part
Muscle weakness only → Heavy physical therapy + quadriceps and hamstring strengthening (3–6 months)
Severe osteoarthritis + instability → eventual knee replacement
Temporarily: Special stabilizing knee brace (with hinge or articulated)
1. Wear appropriate shoes:
Heel maximum 3-4 cm
Wide toes (do not squeeze the big toe)
Avoid pointed and tight shoes 100%
2. Control your weight (every 5 kg of excess weight puts a lot of pressure on the front of the foot)
3. Toe exercises:
Collect towels or marbles with your toes daily
Separate the big toe from the rest with a separator
4. Night insoles and splints (especially if you have a family history or the big toe is slightly crooked)
5. Treat flat feet (medical insoles for the arch of the foot)
Big toe turning towards the second toe
Red, painful bump next to the big toe (bunion)
Pain when wearing shoes (especially tight ones)
Callus or corn on the big toe or second toe
Swelling and inflammation next to the big toe joint
Stiffness and decreased range of motion in the big toe joint
Pain when walking or standing for long periods
Deformity of other toes (hammer toe)
Yes, they can, but with these short conditions:
Mild to moderate osteoarthritis: Yes, even recommended (20–40 minutes of slow walking per day).
Severe osteoarthritis (pain when walking on flat ground): No or only very short and slow, otherwise the pain and swelling will get worse.
Treadmill essentials:
Speed ≤ 4–5 km/h
Incline zero or maximum 1–2%
Must be good shoes with soft/gel soles
If pain or swelling increases afterwards → stop
