Mary Louise, a recently retired office administrator, came to Minnesota Vein Center before proceeding with a right total knee replacement.  She had experienced knee achiness and mild swelling for several years and it had progressively worsened since her retirement. “It’s true, when you retire, you find yourself suddenly more busy.  With  my new and busy schedule, my right knee became very swollen,” she described.  “I developed a bulging lump on the inside and behind my right knee and I had difficulty even playing with my grandchildren. I could only sit or drive for short periods of time”. She made an appointment with her Orthopedic Surgeon to evaluate her worsening problem which she assumed was ‘her bone issue’.  She also saw her Primary Care Physician who was concerned her problem could be related to venous disease.  She was then referred to Minnesota Vein Center for venous disease assessment and was surprised by what Dr. Pal discovered. “They did an ultrasound of both my legs and found the valves of my superficial vein was allowing the blood to flow backwards,” Mary Louise reported.  ” They found the leaking vein started at my groin and went all the way down to just above my ankle. There were congested veins and swelling around my right knee.” Knee arthritis and venous insufficiency often are seen in the same patient because both conditions affect the same population, patients over 40.   Therefore, patients expected to have knee surgery, such as a knee replacement or arthroscopy and who have any signs of venous disease such as swelling or varicose veins should actively seek a venous evaluation prior to major orthopedic surgery. Research has shown that patients who have their venous problems addressed prior to knee replacement or arthroscopy have a better outcome.  Patients can decrease their postoperative risk of leg swelling and deep vein thrombosis when venous disease is addressed first.  With pre-existing swelling, bulging veins or the skin changes of venous disease, vein treatment obviously improves the post-op wound healing process for these orthopedic surgical patients. Forty million adults are affected by venous insufficiency, including one out of three people over the age of fifty.  Treatment by closing defective veins is minimally invasive, taking approximately one hour with rapid recovery times.  This vein treatment enhances a patient’s chance of a good post-operative knee replacement or knee procedural outcome. If you have knee discomfort and are considering or are scheduling an orthopedic evaluation, be sure to consider your vein health.  If you have varicose veins, swelling, leg heaviness or skin discoloration – or have other signs or symptoms of venous insufficiency, request a vein specialist to evaluate your venous status.  Remember that you may enhance your orthopedic procedure outcome by first caring for your venous health.