How Successful are Knee Replacements for Post-Polio Patients and What is Recovery Like?

Question: I am an 83-year-old female polio survivor. The knee on my polio-afflicted right leg is bone-on-bone. My doctor is pressing me to get a knee replacement. How successful are knee replacements for post-polio syndrome patients and what is recovery like?

Marny Eulberg, MD: I don’t have any statistics on success and recovery after knee replacements in polio survivors, and I don’t know even if the topic has been researched or written about other than an occasional “case study.”

As I understand your question, the information you are seeking is, specifically, what is the success rate for knee replacement in a polio survivor’s polio-affected leg that has the specific muscle weakness that you do. Because each polio survivor is unique and their patterns of muscle weakness so different, if I were your physician I would want to know how much strength you have in your quadriceps muscle on that leg, how much hyperextension you have when you stand on that leg, is there any varus (knock-knee positioning) or valgus (bowlegged positioning) of that knee, and what is the status of its collateral ligaments.

I would encourage you to consult with a physical medicine and rehabilitation specialist (physiatrist) before having the surgery. Depending on your muscle weakness in that leg, you may need bracing after the surgery. During the surgery, generally the ACL (anterior cruciate ligament) is cut and not repaired, which can make the knee very unstable and likely to buckle without some form of external support (brace) unless you have normal or nearly normal muscle strength of your quadriceps on that leg. Depending on your situation, a trial of a brace could also significantly decrease your pain and allow to you delay or even avoid surgery.

Post-Polio Health (Vol. 37, No. 4, Winter 2021)