Your knee pain has gotten so bad that it’s keeping you from doing many of the things you enjoy. You can’t kneel to work in your flower beds or stoop to play catch with your grandkids. And forget walking the back nine of your favorite golf course, you can barely make it through the front nine. Arthritis medication isn’t doing the trick anymore and your doctor is recommending total knee replacement.
Undergoing surgery is a scary prospect for most of us. Fortunately, knee replacement surgery is a fairly common procedure with a record of good results. Nearly half-a-million people undergo knee replacement each year and 95 percent of those people experience a big reduction in pain and a big increase in mobility.
Damaged cartilage and bone are replaced by metal and plastic
Your knee replacement will be performed by an orthopaedic surgeon, a doctor who specializes in treating bone and muscle problems. While your doctor will give you specific surgery-prep instructions, count on not being able to eat anything after midnight on the day of the procedure. You probably won’t have to arrive at the hospital until the day of your operation, but you’ll have to stay there for several days of recuperation afterwards.
When you arrive in the operating room, you’ll either be put to sleep using general anesthesia or you’ll be kept awake but given spinal or epidural anesthesia that will numb your legs. Your surgical team will decide which type of anesthesia would be best for you.
Your surgeon will tell you the amount of time he’ll need and the specific steps he’ll take to replace your knee. Generally, total knee replacement takes about two hours. During this time, your surgeon will bend the affected knee in the air and make an eight- to ten-inch incision.
Then he’ll move your knee cap out of the way and take out the cartilage and bone that comprise your old knee. He’ll attach the new knee to your thigh bone (femur) and shin bone (tibia) and also to your knee cap (patella) using bone cement. Then he’ll turn and bend your knee to make sure the prosthesis fits and functions properly.
When your surgery is over, you’ll be taken to recovery where you’ll be monitored for a couple hours until you’re fully awake.
While artificial knee designs and materials can vary, most consist of three parts: a femoral portion made of a strong metal, a plastic patellar piece, and a tibial component, which is often plastic and metal.
Careful, consistent movement is key to knee replacement recovery
Although you’ll be spending several days in the hospital so you can be watched for any signs of infection, blood clots, or nerve damage, you won’t be wiling away the hours lying still in bed. As a matter of fact, you’ll probably be instructed to begin moving your foot and ankle right after surgery to prevent swelling and blood clots.
Because blood clots are the most common complication of knee replacement, your doctor may also require you to wear a compression boot, take blood thinners, and elevate your leg.
The day after your surgery, you’ll start walking with the aid of a walker or crutches. Your doctor may also have you use a continuous passive motion machine, a device that will slowly bend your knee while you’re in bed.
Within a day or two, a physical therapist will show how to perform exercises specifically designed to regain your leg strength and knee mobility. You’ll need to perform these exercises several times a day for many weeks.
Knee replacement isn’t minor surgery, so expect to experience pain and discomfort during your recuperation. While your doctor will give you medication to ease your discomfort, be sure and tell him if the amount of pain you’re experiencing isn’t manageable for you.
Life with your new knee
Be patient with yourself and your new knee. During your first few weeks home after surgery, you’ll need to focus on following your doctor’s exercise and incision-care regimen so you regain knee strength and mobility and protect yourself from infection. By doing so, you should be able to resume most normal daily activities, such as running errands, driving, and doing minor household chores within six weeks.
Once you’re fully recovered, you’ll be able to climb stairs, play golf, swim, and ride a bike. What you won’t be able to do is jog or run, participate in a step aerobics class, or play basketball or any other sport that requires you to jump up and down. Hiking, skiing, tennis, and lots of heavy lifting are also not recommended, so be sure and ask your doctor if you’re not sure about a specific activity.
Remember, your artificial knee can break. However, if you steer clear of high-impact activities, protect yourself from falls, and guard against infection, your knee replacement could last 10 to 15 years.
Infection can occur in your knee years after you’ve had surgery. Be sure to call your doctor if you notice sudden swelling, pain, and redness in your knee. Also, don’t forget to tell your dentist about your knee replacement. If you need dental surgery, you’ll have to take antibiotics before the procedure.