KNEE REPLACEMENT

In General – Knee replacement surgery involves removing the surface of the knee joint and replacing it with metal and plastic surfaces. This is most commonly performed for arthritis of the knee in which the smooth surface cartilage has worn away and bone is rubbing against bone, causing significant pain and deformity.

Reasons To Have The Procedure – Knee replacement works best in patients who have severe arthritis throughout the entire knee. This is most commonly seen in older patients, but can occur in younger patients after infection, or significant injury. The procedure works best if the patient has significant pain and disability before surgery. This includes patients who are limited to less than a quarter mile of walking, have to walk with a cane or a crutch, have pain at night, and who have failed to respond to other forms of treatment, including activity modification, oral anti-inflammatory medications, and cortisone injections into the knee.

What Is Involved With The Procedure – The procedure is done as an inpatient procedure. An incision is made at the front of the knee and the worn-out, deformed surfaces of the knee are removed. They are then replaced with stainless steel surfaces which are held into the bone with glue. Between the two metal surfaces of the shin bone and thigh bone, a teflon-like piece is placed which reduces friction and allows smooth gliding of the knee. A similar teflon-like piece is placed on the backside of the kneecap to prevent pain as the kneecap rubs over the stainless steel portions of the knee replacement. The procedure takes about 90 minutes to perform. Patients are usually admitted to the hospital after surgery for pain control and physical therapy. The average length of stay is about five days.

What Can I Expect Following Knee Replacement? – Most patients have a moderate degree of discomfort in the knee which is effectively treated with pain medications given by the nurses in the hospital for the two days following surgery. Then the pain decreases over the next week or so, and by about two or three weeks after the surgery, patients are feeling much better. It takes about three months for the knee to recover to a point where patients are back to full activities, and up to a year for patients to feel their knee is "normal". Obviously, some patients recover faster and others slower, depending upon factors such as age, health status, and response to rehabilitation.

Most patients are on crutches for about four to six weeks after the surgery and then switched to a cane for the next month or so. Patients are usually given blood thinners to prevent blood clots in the leg following the knee replacement. This lasts for about a month or so following surgery.

Will I Be Able To Go Home After Knee Surgery? – Most patients leave the hospital at about five days following surgery. Patients who live with their spouse, or a person who can assist them, usually are able to go home without much of a problem. However, patients who lived alone prior to surgery often might require a short stay in a rehabilitation center, where they receive physical therapy, instruction in how to take care of themselves at home on their own, and support from the caring staff.

What Activities Can I Do Following Knee Replacement? – The purpose of knee replacement surgery is to relieve pain, allow return to a high level of function. This means that most activities are okay following completion of healing. However, most surgeons recommend that you avoid "impact" type of activities, such as running, aerobics, cutting or pivoting sports, or other activities that place a high degree of stress on the knee. Walking, bicycling, cross-country skiing, and occasionally doubles tennis are often approved.

How Long Does The Knee Replacement Last? – The answer to this question is somewhat variable depending upon the patient's age and activity level. In older (over age 60) patients, about 90 percent of implants are functioning well at 10 to 15 years following surgery. Unfortunately, in young patients, this rate drops to about 50 to 60 percent, usually because their higher level of activity causes wearing out of the prosthetic components. Thus, young patients, who have knee replacement, are often cautioned that they will most likely require at least one additional "re-replacement" during their lifetime.

Can I Have Both Done At The Same Time? – The surgeons at SOFC are highly trained in knee replacement surgery; therefore, we feel very comfortable performing replacement of both knees in the same surgical setting if the degree of arthritis in both is severe. This obviously involves a slower period of recovery, but most patients who undergo bilateral replacements are very happy that they did so following recovery.

Do I Have To Have Knee Replacement Now? – The only way to know for sure is to make an appointment to see one of the physicians at SOFC for examination and x- rays of your knee. We will be happy to take the time to discuss your knee problem in depth with you and make a variety of treatment recommendations based upon the degree of arthritis or other problems in the knee.