Knee replacement surgery is a common and effective procedure for individuals experiencing severe knee pain and mobility issues. It aims to restore function and improve quality of life when conservative treatments no longer provide sufficient relief.
Understanding Knee Replacement
Knee replacement surgery, also known as knee arthroplasty, involves replacing damaged portions of the knee joint with artificial components. These components are typically made of metal and plastic, designed to replicate the natural movement of a healthy knee. The procedure can be either a total knee replacement, addressing all three compartments of the knee, or a partial knee replacement, focusing on specific damaged areas.
Candidates for knee replacement surgery experience persistent and severe knee pain that significantly limits their daily activities, despite trying non-surgical treatments. Conditions such as severe osteoarthritis, a “wear-and-tear” type of arthritis common in older adults, and rheumatoid arthritis, an inflammatory condition, are frequent reasons for considering this surgery.
The Surgical Process and Immediate Recovery
Preparation for knee replacement surgery involves a thorough medical evaluation, including physical exams, blood tests, and imaging, to ensure the patient is healthy enough for the procedure. Surgeons may also recommend pre-operative physical therapy to strengthen muscles and improve overall conditioning. On the day of surgery, anesthesia is administered, which can be general anesthesia to induce sleep or regional anesthesia to numb the lower body.
The surgical procedure lasts between one and three hours, during which the surgeon removes damaged bone and cartilage and then positions the artificial components. Following the surgery, patients are monitored in a recovery room for a few hours before being moved to their hospital room. Pain management begins immediately, often involving a combination of prescription pain medication, nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen.
Early physical therapy is an important part of immediate recovery, often starting within hours or the first day after surgery. Therapists assist patients with standing, walking with assistive devices like walkers or crutches, and performing initial exercises to regain mobility and reduce the risk of blood clots. The hospital stay ranges from one to three days, with some patients even going home the same day if they are in good health and motivated for rapid recovery.
Life After Knee Replacement
Beyond the immediate hospital stay, rehabilitation continues with outpatient physical therapy, exercises, and lifestyle adjustments. Physical therapy sessions, often starting within a week of discharge, focus on strengthening the muscles around the knee, improving range of motion, and regaining balance and coordination. Consistent engagement in these exercises is important for optimal recovery and preventing stiffness or scar tissue formation.
Expected functional improvements after knee replacement include a significant reduction in pain, increased mobility, and a greater ability to resume daily activities. Most individuals can transition to walking without assistive devices within four to six weeks and return to light exercise and low-impact activities within six weeks to three months. A full recovery, with a return to more vigorous activities, can take between three and twelve months.
Knee implants are designed for durability, with most lasting between 15 and 20 years, and some even extending beyond 25 years. Factors influencing implant longevity include the patient’s activity level, with low-impact activities like walking, swimming, and cycling recommended over high-impact sports. Maintaining a healthy weight significantly reduces stress on the knee joint, contributing to the implant’s lifespan. Advances in surgical techniques and implant materials, such as highly crosslinked polyethylene, also play a role in improving long-term outcomes.
Considering Alternatives and Potential Complications
Before considering knee replacement surgery, various non-surgical alternatives can help manage knee pain. These include physical therapy to strengthen muscles and improve flexibility, medications such as over-the-counter pain relievers and anti-inflammatory drugs, and injections like corticosteroids or hyaluronic acid to reduce inflammation and lubricate the joint. Lifestyle modifications, such as weight management and activity modification, can also provide significant relief.
While knee replacement surgery is generally safe and effective, potential complications can occur, though medical advancements have made them less common. These can include infections at the surgical site, blood clots that may form in the leg veins, or nerve damage. Problems with the prosthetic implant, such as loosening or excessive wear, can also arise over time, sometimes necessitating revision surgery.