What You Need to Know About Knee Replacement Surgery
Replacement knees can significantly improve pain and function for those suffering from osteoarthritis or rheumatoid arthritis, while being the keystone of success is patient motivation and commitment to rehabilitation and home exercises.
One potential risk is deep venous thrombosis (DVT), which may form in your leg veins and travel to your lungs (pulmonary embolism). Medication to thin your blood can help decrease this risk.
What is a knee replacement?
Under knee replacement procedures, damaged cartilage and bone are removed and replaced with parts composed of metal or strong plastic. After conducting various tests to assess your knee’s range of movement and stability, a surgeon determines which artificial joint would best suit you based on size, weight, activity level and knee shape – plus which components and surgical techniques best meet those criteria.
Under spinal or general anesthesia, knee replacement surgeries typically are performed without experiencing any pain or discomfort during the process.
Should your knee pain prevent you from sleeping, walking, and caring for yourself effectively, replacement surgery might be required. This surgery should only be used when other treatments do not show improvement.
How is a knee replacement performed?
Before your surgery, you will have a physical exam and require X-rays of your knee and possibly additional tests such as blood work or an electrocardiogram (ECG). Be sure to inform your physician of all medications or supplements you are currently taking as some may need to be discontinued prior to the operation.
Operative procedures typically last 1 to 2 hours. Your surgeon will remove worn ends of thigh and shin bones as well as damaged cartilage before installing metal implants with plastic spacers which allow your knee to bend more freely.
Implant surfaces are usually designed with rough or rough-coated surfaces to encourage bone growth into them, while your surgeon might replace your kneecap (patella). Following surgery, you can either return home or to a rehabilitation center; both options provide opportunities to regain strength and range of motion in your knee; your doctor will prescribe physical therapy accordingly.
Recovery from a knee replacement
Once surgery begins, you will be admitted to hospital and discharged as soon as it is safe to do so. Before leaving, however, a consent form will need to be signed giving permission for your surgeon to carry out treatment and potentially enter details into the National Joint Registry which collects data on knee replacement operations.
Your surgeon will make an incision over your knee and carefully remove damaged tissues and bone fragments before inserting metal implants and cementing them into place.
After surgery, you may experience some discomfort around your knee. This is normal and your surgeon will prescribe painkillers to ease it. Make sure to take these as directed; pressure should not be put on it when possible but you should still use help when walking up or down stairs.
Preparation for a knee replacement
As soon as you are released from hospital, arrange to have someone drive and assist with household tasks. Your hospital stay could last from one to four days and afterwards you may require crutches or walker. Involve a care partner who can assist with meal prep, shopping and cleaning duties if possible.
Before your operation begins, you will be prescribed antibiotics and blood-thinning drugs to prepare you for it. Once on the operating table, your surgeon will make an incision over your knee. Incision length for minimally invasive procedures could reach 30cm; 7-10 inches would apply when performing open procedures.
Your surgeon will use metal implants to replace the damaged portion of your knee, typically cementing them to the remaining bone. As your new knee will move differently than its predecessor, strengthening exercises designed to strengthen muscles surrounding it are recommended to ensure smooth movement.
