Knee replacement surgery is a common and effective procedure that alleviates severe knee pain and improves function. It is an increasingly common option for older adults with significant discomfort and limitations due to knee joint damage. This surgery can restore mobility and enhance overall quality of life, allowing individuals to resume activities they once enjoyed.
What is a Knee Replacement?
A knee replacement, or arthroplasty, involves surgically removing damaged portions of the knee joint and replacing them with artificial components. The procedure addresses worn-out cartilage and bone surfaces of the thigh bone (femur), shin bone (tibia), and sometimes the kneecap (patella). These damaged areas are resurfaced with prosthetic parts.
The artificial components are made from durable materials like metal alloys (cobalt-chromium or titanium) for the femoral and tibial parts, and high-grade plastics (polyethylene) for the liner. The objective is to relieve chronic pain and restore the knee’s ability to bend and straighten. Implants are secured to the bone using bone cement.
Considering Surgery for Older Adults
For older adults, knee replacement surgery is considered when severe knee pain, particularly from osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis, significantly impairs mobility and quality of life. Age alone is not a barrier; a comprehensive evaluation of overall health and mobility goals guides the decision. Good candidates have a stable health status, a strong desire to regain independence, and commitment to rehabilitation.
The procedure can lead to significant pain reduction and enhanced ability to perform daily activities like walking, shopping, and socializing. Benefits include increased independence, reducing reliance on assistance. The goal is to improve function and alleviate discomfort, supporting an active lifestyle.
Preparing for the Procedure
Preparation for knee replacement surgery involves several steps for the best outcome. A comprehensive medical evaluation includes reviewing medical history, current medications, and a physical examination to assess health and identify risks. Blood tests, urinalysis, and an electrocardiogram (EKG) are common diagnostic tests for underlying conditions like heart issues, infections, or diabetes. Dental conditions, such as gum disease, should be addressed before surgery to minimize infection risk to the new joint.
Medication review is important, especially for blood thinners, which may need to be stopped days before surgery to reduce bleeding risks. Pre-operative physical therapy (“prehab”) is a standard practice to improve strength and flexibility before the operation, aiding smoother recovery. Practical home preparations are advised, such as removing tripping hazards, arranging supportive seating, and installing handrails for a safe post-surgery environment. A multidisciplinary team, including geriatricians, physical therapists, and social workers, ensures the patient is prepared for the procedure and recovery.
Life After Knee Replacement
Following knee replacement surgery, recovery begins almost immediately. Patients are encouraged to start moving soon after the procedure, often with assistance from a physical therapist on the same day. Pain management strategies ensure comfort during the initial recovery. Hospital stays typically range from one to five days, with many patients returning home once they can move safely with support.
Physical therapy plays a significant role in regaining strength and mobility, with exercises becoming more challenging over months. While full recovery can take up to 18 months, many patients experience substantial improvement in knee function within 12 weeks. By six months, many older adults return to most daily activities with minor adjustments, experiencing reduced pain and improved quality of life. High-impact activities are generally avoided to preserve the artificial joint, which can last about 20 years; revision surgery within the first 10 years is rare.