What is knee replacement?
When a knee is so severely damaged by disease or injury, an artificial knee replacement may be considered. Approximately 500,000 knee replacement surgeries are performed annually in the US. The most common age for knee replacement is between the ages 60 to 80 years old.
The knee replacement is a metal and plastic covering for raw, arthritic bone ends. It replaces cartilage that has worn away over the years. Knee replacement can eliminate pain and allow you to move easily with less discomfort. For those that have become bow-legged or knock-kneed over the years, it can also straighten your legs to a more natural position.
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Who should have a knee replacement?
When arthritis knee pain severely limits your ability to walk, work, or perform even simple activities, knee replacement should be considered.
The most common condition that results in the need for knee replacement surgery is osteoarthritis, a degenerative, joint disease that affects mostly middle-aged and older adults. Osteoarthritis is characterized by the breakdown of joint cartilage and adjacent bone in the knees. Other forms of arthritis, such as rheumatoid arthritis and arthritis that results from a knee injury can also lead to degeneration of the knee joint. In addition, fractures, torn cartilage, and/or torn ligaments also can lead to irreversible damage to the knee joint over the years.
The decision to replace the painful knee with an artificial one is a joint decision between you and your physician. Other alternative treatments may first be used, including assistive walking devices and anti-inflammatory medications.
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Is there an alternative to knee replacement?
Knee replacement is only recommended after careful diagnosis of your joint problem. Arthroscopic or microscopic surgery is not helpful once arthritis is advanced. Also, it is not likely that anti-inflammatory drugs or cortisone injections will give you the same long-term relief that knee replacement will.
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Should my knee replacement be cemented?
Knee replacements are successfully performed with all cemented components as well as with a combination of uncemented and cemented components. Your surgeon will discuss which technique is best for you.
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How long is the hospital stay?
Knee replacement surgeries usually require an in-hospital stay of several days. Even while in the hospital, the patient usually begins physical therapy exercises to begin regaining range of motion in the knee. Physical therapy will continue at home. Pain medication also will be administered to keep the patient comfortable.
The incision will have stitches or staples that will be removed after a few weeks.
The average hospital stay for a knee replacement patient is around 3-5 days. The average stay for two knees is 5-7 days. If both knees require replacement, it is usually best to have both done at the same time. That way, the total disability will be only slightly longer than the operation for one knee and the problem will be solved in the least amount of time.
In some cases, fixing one knee reduces the stress on the other knee, thus giving another two or three years if the arthritis is not too advanced. Each individual case is different.
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How long is recuperation?
Recovery varies with each person. You will use a walker for approximately 4 weeks after the operation. You can drive a car in 2-4 weeks. Most people gradually increase their activities and may play golf, doubles tennis, shuffleboard, or bowl in 12 weeks. More active sports, such as singles tennis and jogging are not recommended.
After discharge, there is usually no need for a nursing home. Some patients who live alone may require a short stay at a rehab center for a few days after they leave the hospital. This will depend on how you progress in the hospital, and keep in mind that healing and recovery times vary with each person.
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Will I need a blood transfusion?
The need for blood transfusions after knee replacement surgery depends greatly on very individualized factors. The majority of knee replacement patients do not require a transfusion after surgery, but those having both knees replaced at the same time are more likely to need one. Some patients may want to donate their own blood prior to surgery for use after surgery. Your surgeon will be happy to discuss these issues with you.
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What is the success rate?
Knee replacement surgery is recognized as a miracle of modern surgery. Most orthopedic experts consider replacement to be the best method of handling arthritis in the knee. Knee replacements have literally put hundreds of thousands of Americans back on their feet and allowed them to enjoy their golden years.
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Are there complications?
As with any surgery, there is a risk of complications after knee replacement surgery. However, they are quite rare … driving on an interstate highway is probably more dangerous. To reduce the risk of infection, we take special precautionary measures in the operating room, and use powerful antibiotics. Our personnel are limited to fully-trained and experienced nurses and technicians.
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What about pain?
Thanks to advances in medication technology, we are able to keep you very comfortable after surgery. After surgery, any temporary discomfort does not compare to the pain of arthritis endured by most people in months and years before surgery.
And because knee replacement patients are not “sick,” you will not be treated as such. You will wear casual clothing after surgery, not hospital gowns. You’ll also join other joint replacement patients for buffet lunches, television, cards, and games.
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