Knee Replacement

What are the different types of knee replacement surgery?

There are two main types:

• total knee replacement, where the entire joint is replaced with artificial surfaces
• partial knee replacement, where only one damaged compartment of the knee is replaced

Total knee replacement is the more common of these two procedures.

Why Would I Need A Knee Replacement?

Whether to have a knee replacement is a major decision. We may recommend you get a knee replacement if you have knee pain and restricted mobility that doesn’t improve with nonsurgical treatments like physical therapy. Chronic conditions, like arthritis, are the most common reasons for knee replacement surgery. However, a knee replacement may be the solution to a variety of knee problems, like severe fractures or deformities. More than 90% of people who get a knee replacement experience significant pain relief and improvement in their ability to perform daily tasks.

What Should I Expect From Knee Replacement Surgery?

We will perform a physical exam and review your symptoms and medical history to ensure you’re a good candidate for knee replacement surgery. We will also discuss the best type of anesthesia for your procedure, including general anesthesia or a regional nerve block. Knee replacement surgery typically lasts 1-2 hours. During this time, we carefully remove damaged cartilage and bone from your knee and then position the prosthetic joint. After surgery, you may need to stay in the surgery center for a few days. We will work with you to develop a post-surgical rehabilitation plan that may include physical and occupational therapy and advise you on steps you can take at home, like adding a stable bench or chair to your shower.

Knee replacement recovery time and recuperation

Total knee replacement surgery generally takes about 60 to 90 minutes, but you should expect to be in the operating room for over two hours. Rehabilitation (physical therapy) will begin within 24 hours of surgery. After your surgery, the nursing staff will position you in bed and help you turn until you are able to move on your own. You may have a pillow between your legs if ordered by your surgeon. Very soon after surgery, a physical therapist will come to your room to teach you appropriate exercises and review your progress. Gentle exercises to improve your range of motion can help prevent circulation problems as well as strengthen your muscles.

Your rehabilitation program will begin as soon as you are medically stable and there are orders from your doctor to begin postoperative mobility. All patients begin rehabilitation within 24 hours of their surgery. Your motivation and participation in your physical therapy program is key to the success of your surgery and recovery. The physical therapist will assist you in the following activities:

• sitting at bedside with your feet on the floor
• transferring in and out of bed safely
• walking with the aid of a device (walker, cane, or crutches)
• climbing stairs with aid of a device

Risks of the procedure

As with any surgical procedure, complications can occur. Some possible complications may include, but are not limited to, the following:

• Bleeding
• Infection
• Blood clots in the legs or lungs
• Loosening or wearing out of the prosthesis
• Fracture
• Continued pain or stiffness

The replacement knee joint may become loose, be dislodged, or may not work the way it was intended. The joint may have to be replaced again in the future.

Nerves or blood vessels in the area of surgery may be injured, resulting in weakness or numbness. The joint pain may not be relieved by surgery.

There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.

Can I avoid or postpone a knee replacement?

The choice on whether to have surgery to address arthritis of the knee joint depends on multiple factors, including:

• the condition of the knee joint
• the patient’s age and activity level
• In cases where the damage from arthritis is minimal, and/or if the patient does not have a very active lifestyle, nonsurgical treatments by be tried, including:
• physical therapy
• NSAIDs (nonsteroidal anti-inflammatory drugs), such as ibuprofen
• weight loss to reduce pressure on the knee

How long does it take to walk after a knee replacement?

Most patients progress to a straight cane, walker, or crutches within two or three days after surgery. As the days progress, the distance and frequency of walking will increase.

Patients are usually able to drive a car within three to six weeks after surgery and resume all other normal activities by or before six weeks. Complete recuperation and return to full strength and mobility may take up to four months. However, in many cases, patients are significantly more mobile one month after surgery than they were before they had their knee replacement.

Final words

In determining whether a knee replacement is right for you, an orthopedic surgeon assesses your knee’s range of motion, stability, and strength. X-rays help determine the extent of the damage. Your doctor can choose from a variety of knee replacement prostheses and surgical techniques, considering your age, weight, activity level, knee size and shape, and overall health.

For most people, knee replacement provides pain relief, improved mobility, and a better quality of life. And most knee replacements can be expected to last more than 15 years.

Three to six weeks after surgery, you generally can resume most daily activities, such as shopping and light housekeeping. Driving is also possible at around three weeks if you can bend your knee far enough to sit in a car, if you have enough muscle control to operate the brakes and accelerator, and if you’re not still taking narcotic pain medications.

After recovery, you can engage in various low-impact activities, such as walking, swimming, golfing, or biking. But you should avoid higher impact activities — such as jogging, skiing, tennis, and sports that involve contact or jumping. Talk to your doctor about your limitations.