Knee arthritis leads to pain and reduced mobility that leads most patients to have difficulty walking. Pain often becomes more severe over time and during certain activities. Typical methods to combat arthritis symptoms are modifying activities and taking medications. Often, these strategies eventually fail to work. If that is the case for you, you might need a total knee replacement surgery so that damaged surfaces of the knee can be replaced with prostheses, relieving pain, correcting leg deformities, and allowing you to live a normal life. Technological advances have made total knee replacement surgery a successful orthopedic procedure.

Anatomy

The knee is large and everyday activities usually require it. The knee includes the femur, tibia, and patella. The femur is the bottom end thighbone, and it moves around the tibia, which is in the bottom of the leg. The patella is the kneecap. The thigh muscles are long and provide strength for the knee. Large ligaments attach to the femur and tibia to provide stability.

 

Knee Anatomy

Articular cartilage covers the surfaces where bones touch, allowing the bones to move easily over one another with some cushioning. When injury or disease occurs, areas of the knee can be compromised, resulting in pain, weakness, and reduced function.

Cause

Normal joint space between the femur and tibia

Normal joint space between the femur and tibia.

Decreased joint space due to damaged cartilage and bone spurs

Decreased joint space due to damaged cartilage and bone spurs.

Arthritis is a common cause for chronic pain. In osteoarthritis, bones rub together, which leads to pain. This form of arthritis usually occurs in people with family history of the disease and who are above the age of 50.

In rheumatoid arthritis, there’s too much fluid around the joint, causing inflammation, cartilage damage, and pain.

Do you need a total knee replacement?

 

Total Knee Replacement

You and your doctor should discuss the option of whether to get the surgery.

Dr. Samimi will review the results of your evaluation with you and discuss whether total knee replacement would be the best method to relieve your pain and improve your function. He will explain the short-term and long-term potential risks and complications associated with the surgery. Dr. Samimi will make sure that you have all the necessary information to make the right decision. If you choose not to pursue the surgery, there are other treatment options to consider. These treatments include medications, injections, physical therapy, and other types of surgery.

Indications for Total Knee Replacement

If you think you need a total knee replacement, consult your doctor. Anyone is eligible for the procedure, though the majority of patients who have it are between 60 and 80 years old.

Realistic Expectations About Knee Replacement Surgery
Before choosing whether to pursue a total knee replacement you should know what to expect and what not to expect as a result of the surgery.

Expectations About Knee Replacement Surgery

Many patients have pain relief and improvement in mobility. However, the procedure does not enable you to be more active or athletic.

You cannot expect to be able to engage in normal activities immediately following the surgery or to participate in higher impact activities. Even the artificial knee can experience wear, and to avoid this, excessive activity must be avoided.

Your Surgery

If you opt for surgery, an anesthesiologist will assess you upon your arrival to the hospital. General anesthesia is the most common type used for this procedure. This type of anesthesia will put you to sleep. You will also get a nerve block, an injection of numbing medication that will alleviate any pain after surgery.

The surgery takes approximately 2 hours. During this time, the orthopedic doctor will get rid of damaged tissue and attempt to restore your knee by placing new metal and plastic joint surfaces in the knee.

Total Knee Replacement

Following surgery, you have to remain in a recovery room for 1-2 hours. When you wake up, you’ll go back to your room.

Your Stay in the Hospital

Hospital Stay

Following the procedure, you might stay in the hospital for up to 3 days. Medication will help relieve some of your pain. Dr. Samimi knows that it’s important to manage your pain and will take extra care to make sure that your pain is minimal.

Restoring function will begin soon after surgery. Most patients start exercising their knee the day following surgery. A physical therapist will work with you to teach you specific exercises to do to provide information on the recovery process. Dr. Samimi may also give you a knee support that moves your knee for you to help restore movement. This technique, which uses a CPM device, improves circulation by moving the leg muscles. It also reduces swelling in the leg.

Preventing blood clots during recovery is also important. For this goal, the surgeon may provide support hose, compression boots, and/or blood thinners. Moving the leg after surgery can also help prevent swelling and clots.

Complications

The risk of complications with total knee replacement is not high. Potential complications include joint infections, blood clots, heart attacks, and strokes. These complications occur more frequently in patients with chronic illness, and complications may prolong the time to recovery or prevent full recovery.

A complication that occurs with total knee replacement is blood clots in the legs. However, there are ways to prevent blood clots, including leg elevation, leg exercises and support stockings that increase circulation, and taking blood thinner medications.

Though implant materials improve over time, it is still possible for components to endure wear or damage. Additionally, it is also possible to injure nerves and blood vessels that surround the knee during the surgery. Knee scarring can limit the range of motion that patients experience post-surgery.

Wound Care

After surgery, your wound will be dressed.

Diet

You may not be hungry for the weeks following surgery. However, eating well is essential for restoring tissue and muscle strength. Your doctor may recommend that you take an iron supplement during your recovery.

Activity

It is important to get some exercise following surgery. Within 3-6 weeks, you can live a normal life again. However, experiencing mild to moderate pain at night or with activity is normal for weeks.

You may need a physical therapist to help you with these activities during the first several days. Most people can resume driving 4-6 weeks after surgery, but you should be able to sufficiently bend your knee so that you can sit comfortably in a car before you begin driving again.

Preventing Infection

Bacteria is the main cause for infection after surgery. If these bacteria lodge around the knee, they can lead to an infection. It is therefore important to take preventive antibiotics before dental or surgical procedures that could allow bacteria to enter your bloodstream.

If you have any of the following symptoms, you may have an infection: long-lasting fever, chills, knee pain, or discharge from the knee, and you should call your doctor.

How Your New Knee Is Different

After the procedure, you may experience numbness around the incision and stiffness when bending your knee. It is unlikely that you will regain full motion, but you should find that you have more motion than you did before surgery once you are healed. Though kneeling will likely be uncomfortable, it should not harm your new knee. You should also not be alarmed if you notice clicking while bending your knee or walking. Be aware that the new knee trips metal detectors such as those at airports and secure buildings.

After surgery

Following your full knee replacement, you should regularly engage in light exercise to promote strength in the knee. However, you should avoid exercises that have a high risk for falls or injuries, as new injuries will often require additional surgeries.

You also need to let your dentist know you’ve had a knee replacement and take antibiotics before any dental surgery you have at any time after the knee replacement.

Go to the orthopedic surgeon about once a year after your surgery for a check-up.