Use a simple test to help judge your joints

Original article at
Written by Dr. Paul Mackarey / Second of three parts

I had the opportunity to meet with a local man — Bob — who had Mako Robotic-Arm Assisted knee replacement. Talking with him — along with more detailed information from an in-house article from — provided invaluable insight from a patient’s perspective.

Bob, from West Mountain, is a poster child for Mako. He is a 67-year-old engineer who suffered from pain, stiffness and weakness in both knees from advanced arthritis. He had difficulty walking around his workplace and engaging in leisure activities with his friends and family.

Bob relied on nonsteroidal anti-inflammatory drugs and other conservative measures while he researched his best surgical option. Ultimately, he decided to see Dr. John Mercuri, a fellowship-trained orthopedic surgeon specializing in hip and knee replacement who is certified in Mako Robotic-Arm Assisted joint replacement.

Bob had one knee replaced and, three months later, the other using Mako. He credits the same-day surgery and robotic approach for his ability to accelerate his rehabilitation and return to normal activities — such as returning to the gym in 10 days.

“I have a lot to do in life,” Bob said, “hunt, fish, get out in nature and enjoy the world.”

Bob used the lower extremity functional score (LEFS) to indicate his functional levels. Before surgery he was 44% disabled. One month after the second Mako knee replacement, he was 34% disabled. Today, six months later, he is 10% disabled — or 90% functional.

Who is eligible for a new hip or knee?

Hip and knee joint replacement is recommended for people with chronic, disabling arthritic joint pain not responding to conservative management, such as non-steroidal anti-inflammatories, Tylenol, physical therapy, weight loss, activity modification, assistive devices, steroid injections or tramadol.

Most surgical patients are between the ages of 50 and 80, but joint replacements have been performed successfully in patients of all ages. Common physical activities such as bicycling, swimming, golfing and walking are almost always allowed following surgery. Today, with recent advances, the options continue to improve.

New research shows that those who suffer from hip or knee pain due to arthritis for an extended period of time may be doing a great disservice to their overall health and well-being. The results show that over time, those suffering from advanced arthritis of the hip or knee lose their ability to walk more than a city block or two or climb stairs without severe pain. Also, they are unable to use a treadmill, bike, elliptical or stepper for aerobic exercise. As a result of this inactivity, they gain a significant amount of weight and are unable to enjoy traveling or doing things with their family.

In addition to weight gain, a sedentary lifestyle leads to high blood pressure and sleep apnea. Over time, it is likely to lead to coronary artery disease and adult-onset diabetes. Consequently, arthritic pain in the knee can contribute to many health issues.

While surgery should never be taken lightly and is always the last option, sometimes it is the best choice.

How do you know if you’re ready for a new hip or knee? Take the following test. Score each of the following activities on this scale: 0 for extreme difficulty or unable to perform; 1 for quite a bit of difficulty; 2 for moderate difficulty; 3 for a little bit of difficulty; and 4 for no difficulty.

[ ] Usual work, housework, daily activities.
[ ] Hobbies, recreational activities, sports.
[ ] Safely get in and out of a bathtub.
[ ] Walking between rooms.
[ ] Putting on shoes and socks.
[ ] Squatting.
[ ] Lifting objects (like a bag of groceries) from the floor.
[ ] Performing light daily activities at home.
[ ] Performing heavy activities at home.
[ ] Getting in or out of a car.
[ ] Walking two blocks.
[ ] Walking a mile.
[ ] Going up or down 10 steps.
[ ] Standing for one hour.
[ ] Sitting for one hour.
[ ] Running or walking fast on even ground.
[ ] Running or walking fast on uneven ground.
[ ] Making sharp turns while walking fast.
[ ] Hopping or a skip step.
[ ] Rolling or turning in bed.
Total score: _____/80.

The higher the score, the more functional you are and less likely to need surgery for a new knee. For example, 80 out of 80 points is normal. Sixty and above is fairly functional. Forty to 50 points is a danger zone. Below 40 you might start talking to your doctor about surgery. Your orthopedic surgeon will help you decide if a hip or knee replacement is best for you.

Next week, read about the Mako Robotic-Arm Assisted hip and knee replacement.