Total Knee Replacement
If your knee is severely damaged by arthritis or injury, it may be hard for you to perform simple activities such as walking or climbing stairs. You may even begin to feel pain while you are sitting or lying down.
If medications, changing your activity level, and using walking supports are no longer helpful, you may want to consider total knee replacement surgery. Resurfacing the damaged and worn surfaces of the knee can relieve pain, correct leg deformity, and help you resume normal activities.
One of the most important orthopaedic surgical advances of the twentieth century, knee replacement was first performed in 1968. Improvements in surgical materials and techniques since then have greatly increased its effectiveness. Approximately 581,000 knee replacements are performed each year in the United States, unlike the less common ankle replacement.
Whether you have just begun exploring treatment options or have already decided with your orthopaedic surgeon to have total knee replacement surgery, this article will help you understand more about this valuable procedure.
Some patients may be candidates for less invasive procedures such as patellofemoral replacement, meniscus transplant or partial knee replacement.
Treatment
Total knee replacement treatment (also called knee arthroplasty) might be more accurately termed a knee “resurfacing” because only the surfaces of the bones are actually replaced.
There are four basic steps to a knee replacement procedure.
Prepare the bone. The damaged cartilage surfaces at the ends of the femur and tibia are removed, along with a small amount of underlying bone.
Position the metal implants. The removed cartilage and bone is replaced with metal components that recreate the surface of the joint. These metal parts may be cemented or “press-fit” into the bone.
Resurface the patella. The undersurface of the patella (kneecap) is cut and resurfaced with a plastic button. Some surgeons do not resurface the patella, depending upon the case.
Insert a spacer. A medical-grade plastic spacer is inserted between the metal components to create a smooth gliding surface.
Recovery Time
You will most likely stay in the hospital for several days.
The success and recovery time for total knee replacement will depend largely on how well you follow your orthopaedic surgeon’s instructions at home during the first few weeks after surgery.
You will have stitches or staples running along your wound, or a suture beneath your skin on the front of your knee. The stitches or staples will be removed several weeks after surgery. A suture beneath your skin will not require removal.
Exercise is a critical component of home care, particularly during the first few weeks after surgery. You should be able to resume most normal activities of daily living within 3 to 6 weeks following surgery. Some pain with activity and at night is common for several weeks after surgery.
You will most likely be able to resume driving when your knee bends enough that you can enter and sit comfortably in your car, and when your muscle control provides adequate reaction time for braking and acceleration. Most people resume driving approximately 4 to 6 weeks after surgery. Knee replacement hardware lasts around twenty years with about ten percent of patients only making it ten years before the parts wear out requiring knee replacement revision to replace worn out hardware.
