An orthopedic surgeon will determine whether a patient is a candidate for knee replacement. They will assess your knee’s stability, strength, and range of motion. Likewise, X-rays will be used to help doctors determine the extent of knee joint damage.
There are two types of knee replacement procedures, and there are a variety of prostheses to be used depending on a patient’s age, activity level, weight, shape, knee size, and overall health.
Why the Need for Knee Replacement Surgery
Knee replacement surgery is commonly advised to patients to relieve knee pain due to osteoarthritis. Patients may experience issues with walking, getting in and out of chairs, or climbing stairs. Others may even experience knee pain while at rest.
The three most common reasons why this procedure is done are:
Rheumatoid Arthritis – this condition also refers to inflammatory arthritis wherein the membranes surrounding the knee joint thickens and becomes inflamed. The chronic inflammation will damage the knee cartilage, causing stiffness and soreness.
Osteoarthritis – this age-related type of arthritis is due to the normal wear and tear of the knee joints. This condition is common to patients aged 50 or more, but some younger people experience this. Osteoarthritis is pain caused by the inflammation, gradual breakdown, and eventual loss of the cartilage of the knee joint. Over time, the cartilage will wear down until the bones start rubbing together. The bones grow thicker to compensate for the loss of cartilage, but this often results in more pain and friction.
Post-Traumatic Arthritis – this condition is usually due to some severe knee injury wherein the knee bones break or the ligaments tear. This will affect the cartilage and often results in chronic pain.
Who Are Candidates for Knee Replacement Surgery?
Knee replacement may be recommended to patients with the following conditions:
- Chronic inflammation of the knees, as well as swelling that does not improve with rest and medication.
- Severe knee pain and stiffness that hinders patients from carrying out usual tasks and routines like walking, getting in or out from cars or chairs, and climbing up the stairs.
- Knee deformity leading to a noticeable arch inside or outside of the knee
- Moderate yet continuous pain in the knees even while resting or sleeping
- Depression due to the inability to carry out daily activities and social functions.
Ideally, this procedure is the next best option if other treatment options have not worked.
Different Kinds of Knee Replacement Procedures
A patient will be assessed whether they need a partial or total knee replacement procedure.
Total Knee Replacement or the TKR, is the most common procedure for patients needing this type of surgery. It involves the replacement of both parts of the patient’s knee joint. This surgery can last from one to three hours. Patients who had this type of procedure will experience pain relief and better mobility in the knee joints. However, there will be scar tissues, which may cause difficulty in moving or bending the knees.
Partial Knee Replacement or the PKR is recommended for patients with a partly damaged knee. It involves the replacement of only one side of the knee joint. Thus, there is a small incision and less bone removed. However, this type of surgery may not last as long as the Total Knee Replacement.
Rehabilitation for PKR is more comfortable as there is less loss of blood, lower risk of blood clots, and infection. Likewise, hospital stay and recovery is shorter compared to TKR. It also means that there is a higher chance of natural movement after the surgery.
What are the risks involved in Knee Replacement Surgery
Similar to other joint replacement procedures, there are also risks involved in knee replacement surgery. It includes infections, blood clots, stroke, heart attack, and nerve damage.
Look out for signs of infection after your surgery. It is best to notify your doctor if you experience the following sign:
- Drainage from the surgical area
- Fevers higher than 100 F
- Increased tenderness, redness, pain and swelling in the knee
- Shaking Chills
Infection of the knee replacement area may need another surgery to remove the prosthetics and antibiotics medication to kill the bacteria. Once the infection has cleared, another operation will be performed to place a new prosthetic knee.
Prosthetic Knees Can Wear Out
Another potential risk for patients with knee replacement is the failure of the artificial joint. Even the strongest metal and plastic parts will eventually wear out over time. If you are involved in high-impact activities or on the heavy side, the risk of joint failure will be at a higher risk.
How to Prepare for a Knee Replacement Surgery
Knee replacement is a significant procedure that patients should thoroughly prepare for. It would involve pre-surgery preparation, medical consultation, as well as physical evaluations. These activities are to commence a month before the operation date.
The surgeon will perform diagnostics examinations and preliminary tests, including blood count check, test for blood clots, urine tests, an electrocardiogram (ECG) readings.
Patients may have either general, epidural, or spinal anesthetics for this surgery.
During the operation, the orthopedic surgeon will take out the damaged bone and cartilage of the knee joint. Then, a new prosthetic knee made of plastic, metal, or a combination of these two will be positioned to restore the function and alignment of the knee.
Recovery Period After A Knee Replacement Surgery
Patients who have undergone a knee replacement procedure will stay in the hospital for one to three days, depending on how well they recover, follow, and respond to post-recovery rehabilitation.
Expect to experience pain, but the medical staff will encourage patients to try to get up and take a few steps a day after the operation. You will be able to do this with the help of walking aids like crutches or cane. You need to follow the instructions for your rehabilitation to be effective.
Likewise, patients will undergo physical therapy sessions to help strengthen the knee. It will also be painful to experience, but this will significantly lessen the risk of complications in the future.
Patients without home help may need to stay longer in the hospital for better care and assistance.
Post-Operation Recovery at Home
It can take up to three months to completely recover from a knee replacement procedure. Patients may be able to drive usually again four to six weeks after the surgery. Likewise, they may be able to get back to work after six or eight weeks of rehabilitation. During these three months, physical therapy should be consistently provided to strengthen the knees. More so, compliance with the orders of the surgeon, nurses, and physical therapy is essential to their full recovery.
Ideally, knee replacement patients are required to:
- Avoid bending down and lifting heavy items on the first few weeks
- Avoid standing still for an extended period to prevent swelling of the ankles
- Take iron supplements to help in muscle strengthening and wound healing
- Use medications according to instructions
- Utilize crutches, walkers or walking stick until the knee is strong enough to support the bodyweight
- Perform recommended exercises to help in mobility recovery
- Avoid soaking the wound until it is completely healed to prevent infection
- Raise leg on a footstool when sitting
- Look out for signs or symptoms of blood clots, disease or pulmonary embolism
Likewise, patients are cautioned against falls, as it might induce the need for further surgery. Some practical measures to prevent falls or tripping include the following:
- Secure a handrail and use non-slip, stable bench or chair in the shower.
- Sleep downstairs when possible
- Secure loose carpets and remove wrinkly rugs around the home
- Take out or secure trip hazards like loose cables and wires
In most cases, patients can resume their normal activities six weeks after their knee replacement surgery. There will be some pain and swelling for up to three months, and healing of the muscles and scar tissue will take up to two years.
To facilitate safe and secure recovery at home, these changes may be applied –
- Having a reaching stick to get items from the floor
- Have a long-handled shoe-horn
- Have a raised toilet
Results of Knee Replacement Surgery
The procedure aims to provide pain relief, better mobility, and improved quality of life for people with severe knee joint problems. Artificial knees are expected to last more than 15 years.
After their full recovery, patients who had knee replacement can participate in low-impact exercises and moderate activities like walking, biking, and swimming. On the other hand, it is best that they avoid extreme sports like skiing or sports with contact and jumping to prevent injury on their surgical site. Discuss with your surgeon your limitations, but don’t let this stop you from enjoying an active lifestyle.