All you need to know about knee replacement surgery
What is knee replacement surgery?
Knee replacement surgery — also known as knee arthroplasty — can help relieve pain and restore function in severely diseased knee joints.
The goal of knee replacement surgery is to resurface the parts of the knee joint that have been damaged and to relieve knee pain that cannot be controlled by other treatments. Metal and plastic parts are used to cap the ends of the bones that form the knee joint, along with the kneecap.
Basically, there are three sources of arthritis that affect the knee joint:
Osteoarthritis. A degenerative joint disease that affects mostly middle-aged and older adults, causing joint cartilage and surrounding bone in the knee breakdown. Osteoarthritis is the most common cause of damage and causes pain, swelling, and reduced motion in your joints.
Rheumatoid arthritis. It causes inflammation of the synovial lining of the joint and extra synovial fluid.
Traumatic arthritis. This type of arthritis is caused by an injury and damages the knee cartilage.
The type of knee replacement prostheses and surgical techniques for you depends on your age, weight, activity level, knee size and shape, and overall health.
What are the benefits of knee replacement surgery?
The primary benefit is to relieve severe pain caused by arthritis.
People who need knee replacement surgery usually have issues when walking, climbing stairs, and getting in and out of chairs, or even tie their own shoe. Some even have knee pain at rest or sleeping.
This type of surgery can improve your quality of life by countering pain and disability in the knee.
Who is an ideal candidate for knee replacement surgery?
In the United States alone, orthopedic surgeons perform more than 600,000 knee replacements each year.
Patients who experience knee pain from arthritis should consider surgery when:
Their quality of life is significantly affected because of pain and movement limitations.
Non-surgical treatments for pain such as medication and physical therapy are not successful.
Chronic knee inflammation and swelling do not improve after resting.
There are joint degeneration and knee deformity.
If you experience depression, resulting from an inability to carry out daily or social activities.
For diagnosis, your orthopedic surgeon assesses your knee's range of motion, stability, and strength. X-rays help determine the extent of the damage.
Which types of knee replacement surgery are available?
There are four main types of knee replacement surgery:
Total knee replacement: It is the most common procedure and involves both sides of the knee joint. It has a higher success rate.
Partial knee replacement: Aimed to replace only one side of the knee joint.
Kneecap replacement replaces only the under-surface of the kneecap.
Complex knee replacement. For those with very severe arthritis or who have already had more than one knee replacement surgery
What are the risks of knee replacement surgery?
Some possible risks of having knee replacement surgery include:
Dislocation of the new joint or prostheses
Nerve injury resulting in weakness or numbness
Infection at the incision area
Blood clots in the legs or lungs
Talk to your doctor prior to the procedure if you have any other medical condition.
What is the success rate of knee replacement surgery?
In the 2017 study of the medical journal The Lancet, researchers found that:
Among nearly 55,000 people who had a knee replacement, only 3.9% required revision surgery within 10 years of surgery; by 20 years, 10.3% required revision.
Of those over 70 having a knee replacement, the lifetime risk of having a second operation on the replaced joint was about 5%.
One study on long-term outcomes of a commonly used knee and hip replacements published in 2017 found the implant to still be functioning in about 90% of patients 20 years after being implanted.
What should I expect after a knee replacement surgery?
Knee replacement surgery usually requires an in-hospital stay of one to three days.
Following surgery, you need to begin moving the new joint when your doctor recommends it.
A physical therapist will plan an exercise program for you and use a continuous passive motion machine, which moves your new knee joint through its range of motion while you are resting in bed.
Your doctor will prompt you to take good care of the surgical area. Specific bathing instructions are given.
He will also prescribe medication for pain and reduce swelling and apply ice to the knee.
Certain activities like driving are prohibited unless your doctor says otherwise. Usually, patients may normally drive again after four to six weeks, and return to work after six to eight weeks.
According to the American Association of Hip and Knee Surgeons, it can take up to three months to recover completely from a knee replacement surgical procedure.
Patients must comply with the instructions given by doctors, nurses and the physical therapist.
How is the knee replacement surgery recovery like?
Your recovery starts 24 hours after surgery.
At the hospital, you'll be encouraged to move your foot and ankle to increase blood flow to your leg muscles and to prevent swelling and blood clots.
Your orthopedic surgeon will likely prescribe blood thinners and compression boots to further protect against swelling and clotting.
Frequent breathing exercises are highly encouraged and you will gradually increase your activity level.
Your designated physical therapist will show you the proper exercises to continue the recovery at home or at a center.
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