Total Knee Replacement Surgery: What You Need to Know
Knee pain is a common problem that affects many people, especially as they age. Arthritis, injury, and overuse can damage the knee joint, making it hard to perform simple activities like walking, climbing stairs, or getting up from a chair. If you have severe knee pain that limits your quality of life, you may want to consider total knee replacement surgery.
What is total knee replacement surgery?
Total knee replacement surgery, also called knee arthroplasty, is a surgical procedure that removes the damaged ends of the thighbone (femur) and shinbone (tibia) and replaces them with artificial parts made of metal and plastic. These parts are called implants or prostheses, and they form a new knee joint that mimics the natural movement and function of the knee. The surgery also involves resurfacing the kneecap (patella) with a plastic button that fits into a groove in the implant.
Why is total knee replacement surgery done?
The main reason for total knee replacement surgery is to relieve pain caused by arthritis or other conditions that affect the knee joint. Arthritis is a disease that causes the cartilage that cushions the bones of the knee to wear away, resulting in bone rubbing on bone. This causes pain, stiffness, swelling, and reduced mobility. There are different types of arthritis that can affect the knee, such as osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis.
Total knee replacement surgery may also be done to correct a knee deformity, such as a bowlegged or knock-kneed alignment, that interferes with the function and stability of the knee. Additionally, total knee replacement surgery may be done to treat a knee injury, such as a fracture, ligament tear, or infection, that has damaged the knee joint beyond repair.
What are the benefits and risks of total knee replacement surgery?
Total knee replacement surgery can provide significant benefits for people who suffer from chronic knee pain and disability. The surgery can:
- Reduce or eliminate knee pain
- Improve knee function and mobility
- Enhance quality of life and well-being
- Enable participation in physical and social activities
However, like any surgery, total knee replacement surgery also has some risks and complications. These include:
- Infection of the wound or the implant
- Bleeding or hematoma (a collection of blood) around the knee
- Blood clots in the leg or lung
- Nerve or blood vessel injury
- Loosening or wear of the implant
- Fracture of the bone around the implant
- Stiffness or limited range of motion of the knee
- Allergic reaction to the implant materials
- Need for revision surgery
How do you prepare for total knee replacement surgery?
Before total knee replacement surgery, you will need to undergo a thorough evaluation by your doctor and your orthopedic surgeon. They will review your medical history, perform a physical examination, and order some tests, such as blood tests, X-rays, and MRI scans, to assess the condition of your knee and your overall health. They will also discuss with you the benefits and risks of the surgery, the type and design of the implant, the anesthesia options, and the post-operative care and rehabilitation plan.
You will also need to prepare yourself and your home for the surgery and the recovery period. Some of the things you may need to do are:
- Stop taking certain medications and supplements that may increase bleeding or interfere with healing
- Quit smoking and limit alcohol intake to improve wound healing and reduce infection risk
- Arrange for someone to drive you home from the hospital and help you with daily tasks for a few weeks
- Stock up on food, water, and other essentials
- Set up a comfortable and accessible living space on one floor, as you may have difficulty climbing stairs
- Gather the equipment and supplies you will need, such as crutches, walker, ice packs, and dressing materials
- Follow the instructions given by your doctor and surgeon regarding fasting, bathing, and medication use before the surgery
What happens during and after total knee replacement surgery?
Total knee replacement surgery is usually done under general anesthesia, which means you will be asleep and not feel any pain. The surgery typically takes about one to two hours, depending on the complexity of the case. The surgeon will make an incision in the front of your knee and move your kneecap aside to expose the knee joint. The surgeon will then remove the damaged bone and cartilage from the femur and tibia and shape the remaining bone to fit the implant. The surgeon will then attach the implant to the bone using cement or screws and place the plastic button on the kneecap. The surgeon will then close the incision with stitches or staples and cover it with a bandage.
After the surgery, you will be taken to a recovery room, where you will be monitored for any signs of complications. You will also receive pain medication and antibiotics to prevent infection. You will stay in the hospital for a few days, during which you will start physical therapy to restore your knee function and strength. You will learn how to walk with crutches or a walker, how to bend and straighten your knee, and how to perform exercises to improve your range of motion and muscle tone. You will also learn how to care for your wound and prevent blood clots.
You will be discharged from the hospital when you are able to walk safely, manage your pain, and perform basic activities of daily living. You will need to continue physical therapy at home or at an outpatient facility for several weeks or months, depending on your progress and goals. You will also need to follow the instructions given by your doctor and surgeon regarding wound care, medication use, activity level, and follow-up visits.
What is the outlook for total knee replacement surgery?
Total knee replacement surgery can provide lasting relief from knee pain and improve your quality of life. Most people who undergo total knee replacement surgery are able to resume their normal activities within three to six months, although some may take longer. The results of total knee replacement surgery are generally very good, with more than 90% of implants lasting for 15 to 20 years or longer. However, some factors may affect the longevity and performance of the implant, such as your age, weight, activity level, and health condition. Therefore, it is important to follow the recommendations of your doctor and surgeon to protect your new knee and prevent complications. You should also report any signs of infection, inflammation, loosening, or wear of the implant, such as fever, redness, swelling, warmth, pain, or instability of the knee.
Total knee replacement surgery is a major decision that requires careful consideration and consultation with your doctor and surgeon. If you have severe knee pain that interferes with your daily life, you may benefit from this procedure. However, you should also be aware of the potential risks and complications, as well as the need for lifelong care and maintenance of your new knee. By weighing the pros and cons of total knee replacement surgery, you can make an informed choice that suits your needs and expectations..
Source: Conversation with Bing, 12/13/2023
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