Osteoarthritis (OA) is the commonest form of knee arthritis that can result in significant pain, swelling, and disability. Symptoms are often worse in standing or walking. In advanced arthritis, even daily routine activities can become a challenge. When mobility is restricted and pain becomes too significant, knee replacement surgery may be an option.
Most of the people who undergo knee replacement surgery report significant improvement in their pain.
Knee replacement surgery is of different types. Options include:
- Total knee replacement: the whole knee is replaced
- partial knee replacement: only the affected half of the knee is replaced
In most cases, people undergo knee replacement surgery for Osteo-Arthritis. Knee replacement is a very-very commonly done operation. Every year, surgeons perform approximately 2.6 million knee replacement surgeries worldwide.
What happens during the knee replacement procedure?
Most knee replacement surgery is performed under either general anesthesia, peripheral nerve blocks, and spinal (epidural) anesthesia. Antibiotics are given to reduce the risk of infection.
During the procedure, the surgeon removes the affected bone and diseased cartilage from the articulating surface of the thigh bone (femur) and shin bone (tibia) at the knee joint.
Those surfaces are then capped with a metal implant. A piece of special highly cross-linked plastic is used to replace the backside of the kneecap bone. Insert made of the same plastic material is placed in between the two metal parts.
This provides knee joint smooth surfaces so they can glide and bend more freely and painlessly.
After the knee replacement surgery
Most patients stay 2–3 days in the hospital after a total knee replacement.
The doctor prescribes pain medication and will start rehabilitation and physiotherapy. Also, monitor you for complications.
Physical therapy is started once the patient stabilizes and pain reduces, usually the next day: this includes two separate methods:
- Use of the new joint like, weight-bearing, standing, and walking
- physical and occupational therapy combination to help adapt to the new knee
You will have to continue these exercises at home regularly.
Once you are able to get out of bed alone and use the bathroom, you will go home.
You will need to use a stick or a walker for a short period of time after your surgery.
Total knee replacement recovery
Most part of your recovery and rehabilitation will happen at home once you leave the hospital after surgery. Few people need health care at home or assistance.
Your doctor will advise physical therapy at a local clinic or at your home for continued accelerated rehabilitation. The physical therapist will suggest, demonstrate and teach exercises you can do at home.
Everyone recovers at a different pace, but most people can return to driving by the end of 4 weeks.
It is always advised to prepare your home for rehabilitation after your return from surgery.
Preparing for knee replacement surgery
Sometime before the surgery, your surgeon will take you through a preoperative check-up.
They will ask you simple questions about:
- your overall health condition
- your medical history
- any medications or supplements or drugs you use
- any specific queries you may have
They will also:
Carry out a few tests to check if you are ready for the surgery and assess for possible complications. These can include kidney and lung tests.
Ask you to give written consent and provide details of people to contact in an emergency.
Inform you of any preparations you should make before surgery. For example, you may need to stop certain medications temporarily.
Total knee replacement cost
The cost of a knee replacement varies greatly, depending on where which country, which hospital you have the procedure, and your overall health.
Some conditions that are not related to your knees, can also affect the procedure and cost as well.
When budgeting the cost of the procedure, you should also consider additional costs for:
- extended hospital stay
- physical therapy at home
- recovery at home
- follow-up appointments in OPD
- help at home
- transportation costs
You should also consider how much your insurance will cover and how much you’ll need to pay from your own pocket.
Exercises are centric in preventing knee damage, supporting the knee during treatment, and faster recovery.
Exercise helps prevent joint damage by:
- strengthening the muscles around the knee joint
- helping you maintain weight
This is true for both before and after surgery and for the natural and the artificial knee.
Persistent pain and limited mobility can increase the risk of social isolation. Exercise with a peer group may be a good way to connect with other people, a few of whom may have similar health issues.
Physical activity can also help you with positive vibes and reduce the risk of anxiety and depression.
Which exercises for the knee?
American College of Rheumatology/Arthritis Foundation has issued guidelines that strongly recommend exercises for managing OA of the knee.
Activities that can prove useful are:
- strengthening exercises
- water exercise
- tai chi
Alongside exercise, weight is also crucial for managing OA of the knee.
After a knee replacement, your physical therapist will most likely have an exercise routine for you to follow.
This will include getting back up on your feet as soon as possible after surgery and walking a little more every day.
These exercises will help strengthen the muscles of your knee and speed up your healing.
It is important to follow protocol carefully so that your recovery is well on track. It will help you return to your everyday activities as quickly as possible.
It will also help you set a routine that will support your health on an ongoing basis.
Knee replacement surgery pain
You may have pain for a while after your knee replacement, but your knee replacement surgeon will provide you with medications to help manage this.
All surgery involves some complications. After a knee replacement surgery, there can be a risk of:
- blood clots
- continuing pain, even when surgery is successful
Most people don’t experience any severe complications and are very happy after relief of knee pain. The healthcare team will make sure the risks are as low as possible.
How long does a replaced knee last?
Replaced knees can wear out, at which point a second knee replacement surgery may be needed. However, research shows that over 82 percent of replacement knees are still functioning 25 years later.
Who should consider knee replacement surgery?
Osteoarthritis is the most common reason that people have knee surgery but knee replacement surgery may also be needed in people with:
- An old knee injury such as a ligament tear or meniscus tear
- a knee deformity that they were born with
- rheumatoid arthritis
Most people with knee pain do not require knee surgery and can be treated non-operatively. Your doctor may advise:
- losing weight
- getting more exercise or following a specific exercise plan
- using over-the-counter pain killers or other medications
Making the decision
The doctor may do some tests to see if you need surgery, and you can ask questions.
In all cases, a total knee replacement reduces the pain and improves mobility. However, surgery is costly, and it can take several weeks or months for recovery. There is also a small risk of complications.
For these reasons, you should understand as much as you can about the benefits and risks of knee replacement surgery before going ahead.
Partial knee replacement
In a partial knee replacement surgery, the surgeon only replaces the damaged part of your knee.
Compared with a total knee replacement, this procedure has these advantages:
- Needs a smaller incision.
- Less loss of bone and blood.
- Recovery is faster and less painful.
However, if you have a partial knee replacement surgery, you may need another surgery later if arthritis develops in the other parts of the knee.
Bilateral knee replacement
In a bilateral or double knee replacement, the surgeon replaces both the knees at the same time in one sitting usually.
If you have OA in both knees, this is a good option, as you only have to go through the procedure and recovery process only once. And is economical as well.
However, rehabilitation takes longer and you will need much more help during recovery.
Knee replacement is a very commonly performed surgery.
After surgery and recovery, most people are able to participate in activities, such as walking, bicycling, golf, tennis, and swimming.
As there is always some risk with any surgery, this procedure is considered quite safe, and most people experience pain relief and increased mobility.
Before deciding, however, discuss the pros and cons with your healthcare provider, including the cost of surgery and the amount of time you may need before you join work.
For most, knee surgery can improve their function from day to day and their quality of life connect with the Chirurgie.