What is knee replacement surgery?

A knee replacement is a surgery to replace all or some knee joints. This procedure is also known as an arthroplasty or joint replacement.

A surgeon will remove damaged parts of your natural knee joint and replace them with an artificial joint made of metal and plastic.

Knee replacement types:

Your surgeon will advise on either total or partial knee replacement:

Total knee replacement: This is the most common form of knee replacement. Your surgeon will replace all three parts of your knee joint, including the medial, lateral, and the one underneath your kneecap, the patella femoral.
Partial knee replacement: A partial knee replacement is precisely what it's called. Your surgeon will only replace some parts of your knee joint - usually if only one or two parts are damaged. Partial knee replacements are more common in younger adults who have suffered an injury or trauma.

What conditions are treated with a knee replacement?

A healthcare professional may recommend a knee replacement if you are experiencing severe symptoms that do not subside even after non-surgical treatments, which may include:

Pain in the joint.
Stiffness
Inability to move the knee.
Swelling

By far, arthritis is the leading underlying condition that causes people to decide to have knee replacement surgery. Most patients choosing to undergo a replacement suffer from osteoarthritis, while some with rheumatoid arthritis may also need one.

While this is very rare, a healthcare provider may recommend knee replacement if you have suffered from a bone fracture in the knee that causes post-traumatic arthritis after you have had:

Car accident.
Fall
Sports injury.

How do I prepare for a knee replacement?

Your healthcare provider and surgeon will instruct you on preparing for surgery. Generally, you will need:

Physical examination to determine that you are fit to be operated on
Blood tests.
Test: You will be given an electrocardiogram to assess your heart condition.
You will also receive a dental check-up to prevent you from developing an infection after surgery.
Imaging test: For example, you will be required to have an X-ray of your knee. You might also have MRI or computed tomography (CT) scans.
Advice your provider and surgeon about all medicines and supplements you are taking. You may be asked to discontinue some of them before surgery is performed.

Your surgeon will indicate when you should stop eating and drinking the day before surgery. Most patients need to avoid any food or liquid intake for 12 hours prior to surgery.

What happens during a knee replacement?

On the day of surgery, you will receive anesthesia to numb your body and ensure you do not feel pain. An anesthesiologist will give either general anesthesia, which puts you to sleep during your surgery, or regional anesthesia, which numbs you from the waist down.

In a knee replacement, the surgeon will remove damaged cartilage and bone and insert a prosthetic knee joint.

Insert a plastic spacer that recreates the smooth cushion of your damaged or removed cartilage.

Shape your patella (kneecap) to fit the new prosthetic knee joint (if needed).

How long does knee replacement take?

Knee replacements usually take 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. Where the prosthetic joint differs is that it is made of metal and plastic instead of bone and cartilage. It is designed to replicate a natural knee joint's shape, size, and function.

What happens after a knee replacement?

After the surgery, you are whisked to a recovery room. You are kept under the surveillance of a surgery team for a few hours in case complications start arising during the coming around from the anesthesia effects. Your vital signs and levels of pain are closely monitored.

Most patients with knee replacement surgery spend overnight at home, 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 main idea behind knee arthroplasty is that it is a relatively safe and effective procedure intended to help people regain their mobility and relieve pain in the long term. Most patients who have had a knee replacement note a reduction of pain, enhanced ability to move and use their knee, and improved quality of life.

How long does a knee replacement last?

A knee replacement usually is very durable. In fact, more than 90 percent of the patients who are 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, such as the device wearing out too quickly or loosening
Scar tissue in your knee
Decreased range of motion (how well you can bend and straighten your knee) and stiffness

Some medical conditions make it more difficult for your knee to heal after a replacement. Discuss your medical history with your surgeon. Tell them if you have:

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

How long does it take to recover fully after a knee replacement?

In general, full recovery from knee replacement takes about one year. Still, you can return to most of your usual activities after six weeks since your surgery.

The time taken to recover will depend on some of the factors, which include your

Activity level before surgery.
age
Other medical conditions.

Your surgeon will have a customized post-operative care plan for you, but for the most part, you will:

Apply ice to your knee: Ice the area a few times a day, even with the application on, for about 20 minutes to reduce pain and inflammation.
Elevate your knee: Try to elevate it above the level of your heart as much as possible. When lying down, support your knee with cushions or pillows, or use a footstool when sitting in a chair.
Maintain a clean and covered incision: Always follow your surgeon's instructions carefully regarding aftercare for your incision. Ask your surgeon how soon you should change the dressing at the site of your incision and how soon you can return to showering or bathing.
Home exercises: Your surgeon will give you exercises right after surgery. They shall teach you how to move and execute movements and exercises to strengthen the muscles around your knee and prevent stiffness. Carry out your exercises as frequently as your surgeon suggests. This will help in recovery and see your joint regain its functional state.

You will likely start working with a physical therapist within a few weeks after your surgery, continuing for a few months. A therapist will help you learn to bend your knee and walk safely safely. Pain management after knee replacement

After surgery, pain is both expected and inevitable. This most probably begins in the first two weeks of your recovery phase.

Your surgeon will recommend prescription pain medication, over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) if it is appropriate for you to take them, and acetaminophen to manage your pain. Your surgeon will advise you on how much each type you may take in a day or amount at a given period.

Tell your surgeon if you feel that you are experiencing too much discomfort or concern about potential complications from taking pain medication.

When can I return to work or school after knee replacement?

The amount of time you will need to be out of work or school will depend upon just how stressful your job or other activities are on your knee. Most people need to take a few weeks at home to recover from knee replacement surgery, and your surgeon will inform you when it would be appropriate for you to return to work or school.

What can I do to support my recovery after knee replacement?

You can ambulate with a cane or walker a few days after surgery. However, you'll likely need some help with certain daily activities, such as:

Bathing.
Cleaning.
Washing clothes.
Cooking.
Shopping.
Plan for your surgery: You can ask your surgeon or healthcare provider for recommendations of resources should you need them while recovering.

Your recovery will be easier and safer if you prepare your home ahead of time. This includes:

Ensuring the path to your bathroom is apparent and arranging for grab bars, if possible
Removing loose rugs
Having an easy-to-use walker or cane handy, should you need it
Get a bench or chair for your shower.
Install grab bars or get a commode chair to assist you in getting on and off the toilet.
Clear all tripping hazards like power cords, rugs, and loose carpets.
Secure handrails along any stairs.

When should I call my healthcare provider?

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

Chest pain.
Shortness of breath (dyspnea).
Fever over 101 degrees Fahrenheit (39 degrees Celsius)
Bleeding
There are signs of infection at the surgical site, such as leaking, swelling, discoloration, odor, or a feeling of warmth.
New onset of pain, increasing pain in your calf, ankle, or foot.
Severe pain that is not relieved by pain medication.