What is a knee replacement?

A knee replacement is a surgery where all or part of the knee joints are replaced. Some people might call this surgery arthroplasty or joint replacement.

The diseased parts of your knee joint will be removed and replaced with a healthy artificial knee made of metal and plastic by a surgeon.

Types of knee replacement:

Your surgeon is going to recommend either total or partial knee replacement:

Total knee replacement: This is the most common kind of knee replacement. Your surgeon will replace all three parts of your knee joint: the medial, the lateral, and the one under your kneecap, the patella femoral.

Partial knee replacement: A partial knee replacement is simply what it says. Your surgeon will only be replacing some part of your knee joint usually only because only one or two parts are damaged. Partial knee replacements often tend to occur more frequently among younger adults who have injured or traumatized themselves in one way or another.

Which conditions is used in knee replacement?

A medical doctor may choose to recommend a knee replacement if the symptoms are severe and do not lessen with the non-surgical treatments that may be comprised of:

• Stiffness.
• Swelling.
• The patient cannot move the knee.
• Pain in the joint.

By far, arthritis is the most common underlying problem that makes people choose to opt for knee replacement surgery. Most patients opting to undergo a replacement suffer from osteoarthritis, whereas others with rheumatoid arthritis may also require one.

Although this rarely happens, a doctor would advise knee replacement when you have experienced a fracture of the bone in the knee that results in post-traumatic arthritis after you have had:

• Car accident.
• Fall
• Sports injury.

How do I prepare for a knee replacement?

Your surgeon and healthcare provider will provide you with detailed preparations on surgery. You will be required to have:

• Physical check-up to confirm you are fit to be operated on
• Blood tests.
• Test: You will be given an electrocardiogram to evaluate your heart status.
• You will also receive a dental check-up not to develop an infection after the surgery
• Imaging test: For example, you will be prescribed to take an X-ray of your knee. You might also undergo MRI or computed tomography (CT) scans.

Discuss all medications and supplements you are taking with your provider and surgeon. You may be told to stop some of these before surgery is performed on you.

Your surgeon will tell you when you should stop eating and drinking the day before surgery. Most patients must stop any food or liquid 12 hours before surgery.

What happens during a knee replacement?

During surgery, anesthesia is provided to make your entire body numb so that you do not feel anything. You are either under general anesthesia, where you sleep throughout your surgery, or regional anesthesia, which numbs you from waist down. When the knee replacement is performed, the surgeon removes damaged cartilage and bone and inserts a prosthetic knee joint.

• Add a plastic spacer miming the mushy cushioning of the missing or damaged cartilage.
• Shapen the kneecap (patella) to fit the prosthetic knee joint (in applicable cases).

How long does a knee replacement take?

A knee replacement usually takes about an hour or two.

What does a knee replacement look like?

The prosthetic parts your surgeon will use during a knee replacement are similar to your original knee. The difference, however, is that the prosthetic joint comprises metal and plastic instead of bone and cartilage. It's engineered to come as close as possible in mimicking a natural knee joint's shape, size, and function.

What follows after a knee replacement?

You are taken to a recovery room following the surgery. You are monitored by the surgical team for several hours in case complications start surfacing during the recovery from the effects of anesthetics. Your vital signs and your levels of pain are monitored regularly.

Most patients spend an overnight at home following knee replacement surgery, while others are usually required to spend one night in the hospital. Your surgeon will tell you when you can be discharged home. Why would any benefits occur with a knee replacement surgery?

The basic concept behind knee arthroplasty is that it is a relatively safe and effective procedure aimed at helping people regains their mobility, which ultimately helps alleviate pain. Most patients who have undergone knee replacement report declining pain, improved ability to move and use their knee, and improved quality of life.

How long does a knee replacement last?

A knee replacement normally is very durable. More than 90 percent of the patients forced to have a knee replacement still have improved function in their knee between 10 to 15 years.

What are the possible complications of a knee replacement?

Some patients who undergo knee replacement surgery still complain of pain and other symptoms within the knee. Some less common complications include:

• Blood clots.
• Infection in your knee or at your surgery site.
• Nerve problems
• Blood vessel problems
• Problems with the implant, including premature wear or loosening
• Scar tissue in your knee
• Reduced flexibility (ability to bend and straighten your knee) and stiffness

Some medical conditions make it harder for your knee to heal after a replacement. Discuss your medical history with your surgeon. Let them know if you have:

• Hemophilia
• Diabetes
• Other autoimmune diseases (such as lupus).
• Your surgeon will tell you what to expect in your early recovery period and how to avoid complications.

What is the length of time to completely heal after knee replacement?

In general, complete recovery from knee replacement takes one year, but you can return to most of your normal activities after six weeks following your surgery.

Recovery time will vary based on some factors, such as your

• Activity level before surgery.
• Age
• Other health conditions.

Your surgeon should have a specific post-surgical recovery plan for you; however, generally speaking, you will:

Use ice on your knee: Apply ice to the area throughout the day even with the application on for about 20 minutes to reduce pain and inflammation.

Raise your knee: As much as you can, raise it above the level of your heart. If you're in bed, place cushions or pillows under your knee. If you're sitting in a chair, use a footstool.

Clean, covered incision: Always follow your surgeon's instructions about aftercare for the incision site. Be sure to ask your surgeon how soon you must change your dressing and how soon you can get back to showering or bathing.

Home exercises: Your surgeon will instruct you in exercises at the time of surgery. They will be teaching you how to move and perform movements and exercises for strengthening muscles around your knee, preventing stiffness. Do your exercises as often as your surgeon advises. This will assist you during recovery and to see your joint return to its functional state.

You will probably start seeing a physical therapist in a few weeks after surgery, then for several months after that. This individual will help you learn to safely bend your knee and walk safely. Managing pain after knee replacement

Pain is both expected and unavoidable after surgery. It most likely occurs within the first two weeks of your recovery phase.

The surgeon will advise you on prescription pain medications, over-the-counter NSAIDs if appropriate for you to take them, and acetaminophen to manage your pain. Your surgeon will also advise you on the amount of each type you may take in a day or at a given period.

Let your surgeon know if you feel that you are feeling too much pain or are anxious about potential complications due to the pain medication.

How soon can I return to work or school following knee replacement?

The amount of time you will need to be out of work or school depends on how physically demanding your job or other activities are on your knee. Most patients need a few weeks at home before they can return to work or school, and the surgeon will be able to tell you when that would be appropriate for you to do again.

What's my end-care post-knee replacement?

You'll be able to use a cane or walker the third day post-op and still need help with the following basic activities:

• Bathing.
• Household cleaning.
• Laundry
• Cooking
• Shopping
• Plan for your surgery.

You can ask your surgeon or healthcare provider for recommendations of resources should you need them while recovering. Prepare your home in advance to make your recovery easier and safer. This will involve:

• Making the way to your bathroom clear and arranging to have installed, if possible, grab bars
• Moving loose rugs
• Having an easily accessible walker or cane available should you need it
• Install grab bars or a commode chair to help you get on and off the toilet.
• Eliminate all tripping hazards, such as electric cords, rugs, and loose carpets.
• Install handrails along any stairs.

When to Call a Doctor?

Call your surgeon or healthcare provider immediately if you have any of the following:

• Chest pain.
• Difficulty breathing (dyspnea).
• Fever over 101 degrees F (39 degrees C)
• Bleeding
• There are signs of infection at the surgical site, including leaking, swelling, discoloration, odor, or a feeling of warmth.
• New onset or worsening pain in your calf, ankle, or foot.
• Worsening in intensity that doesn't diminish with pain medication.

To seek an expert consultation for any orthopedic condition.

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