Total Knee Replacement
What is a Total Knee Replacement?
Knee replacement surgery is the procedure performed to repair severe damage to the knee joint. This surgery may be considered when more conservative therapies are no longer helping to reduce pain and improve physical mobility. A total knee replacement removes damaged joint structure, including bone and cartilage, and replaces them with plastic and metal fixtures that stabilize the joint space.
What Causes Knee Pain?
Chronic knee pain is nearly always caused by arthritis. There are various types of arthritis, but three have been associated with potentially debilitating knee pain. These include:
This condition is related to the wear and tear on the joints over time. Related to age, osteoarthritis is typically diagnosed in adults over the age of 50. Pain occurs when the cartilage that pads the knee joint degrades. As this happens, the bones that make up the knee joint may then wear down, as well, due to friction. This results in pain and stiffness.
This type of arthritis is a byproduct of an injury to the knee joint. Injury may have initially damaged a ligament or tendon or may have fractured a bone. These types of injuries can lead to damage in the articular cartilage, resulting in a limited range of motion and pain.
This form of arthritis is inflammatory and related to the immune system. It is a chronic disease that causes the synovial membrane around the knee joint to become thickened and inflamed. The chronic inflammation of this membrane results in damage and cartilage loss.
What Conditions May Cause the Need for a Total Knee Replacement?
Osteoarthritis is the most common condition that leads to a need for total knee replacement. However, injuries to this joint could also cause substantial damage that requires surgical repair.
What Are the Signs of Needing a Knee Replacement?
If you are experiencing knee pain and stiffness that inhibits your daily activities, see an orthopedic specialist. Signs that knee replacement surgery may be needed include:
- Limitations in daily activities such as climbing stairs, walking and getting in and out of chairs indicate that the knee joint may need repair.
- Moderate to severe knee pain when at rest. Knee pain that wakes you up at night.
- Deformity of the leg, such as bowing of the knee.
- Chronic pain and swelling do not improve with medication and rest.
- Conservative remedies like medication, rest, and physical therapy are not improving comfort and range of motion.
How long will a Knee Replacement Last? Will I Ever Need a Second Knee Replacement?
Studies suggest that more than 90% of knee replacement procedures are successful in the goal of reducing pain and improving mobility and quality of life. It is important to understand that knee replacement surgery will not allow more movement than was possible before arthritis developed. The new knee joint can last several years, though wear and tear are expected, just as it is with natural joint structure. Normal daily activities will gradually degrade the joint. This process may be accelerated by excessive weight or the routine performance of high-impact activities. After a knee replacement, many doctors advise against jumping activities, running, and high-impact sports. Those who undergo knee replacement can expect to comfortably walk, swim, golf, dance, bike, hike, and enjoy low-impact sports. With these activities, a knee replacement can last many years.
How Is a Total Knee Replacement Performed?
Knee replacement surgery is generally performed in a hospital operating room. During the in-patient procedure, diseased bone and cartilage are removed from the knee joint (where the femur and tibia meet). The surfaces that have been removed are replaced with a metal implant. A special plastic implant is normally placed at the backside of the kneecap and also in between the two metal parts of the artificial knee joint. The metal and plastic restore the smooth surface of the knee joint to support flexion and comfortable bending.
“Having my knee surgery done by Dr. Petraco was one of the best decisions I’ve ever made. I am only 2 weeks post-surgery and very surprised at how well I am doing.”
How Long is Recovery After Knee Replacement Surgery?
Patients may spend a few days in the hospital after total knee replacement surgery. Recovery and rehabilitation are critical aspects of returning to an active lifestyle, so physical therapy usually begins the day following surgery. At discharge, patients may be able to stand on their own with little or no assistance. They may be able to use the bathroom, bathe, and dress and go on slightly longer walks. Finally, patients may be able to go up and down a flight of stairs by the time they are released from the hospital. These improvements develop within the first few days of recovery. However, patients need to commit to their ongoing rehabilitation. With consistent work, many normal activities can resume in the 12 weeks after knee replacement.
What is the Importance of Physical Therapy after Knee Replacement?
Rehabilitation is one of the most important aspects of total knee replacement. Proper care is essential to restoring optimal comfort and range of motion. The purpose of physical therapy after total knee replacement is to regain strength and movement. Initially, patients may need a walker or crutches to walk. Gentle physical therapy improves the ability to bear weight on the new joint. Range of motion exercises prevents scar tissue from obstructing the flexibility of the new joint.
Are There Any Risks Involved with Total Knee Replacement Surgery?
More than 600,000 knee replacement procedures are performed each year. Rates of infection are lower than 2 percent. Possible risks include anesthesia reaction, infection, blood clots, and poor healing. With good care after surgery, these risks are significantly decreased.
- National Institutes of Health
- Centers for Disease Control and Prevention
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- U.S. Department of Health & Human Services
- U.S. National Library of Medicine
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