Knee replacement surgery might be an option for you if you’ve been dealing with knee discomfort for a long time and are finding it more and more challenging to carry out the activities that are essential to your day-to-day functioning.
In the United States in 2017, there were more than 745,000 procedures performed to replace knees. When they reach the age of 80, more than one in ten people living in the United States will have undergone a knee replacement procedure.
On the other hand, the age that people are when they have knee replacement surgery has been becoming younger over the years. The American Academy of Orthopaedic Surgeons reports that the typical age of a patient who undergoes a knee replacement procedure is 65.9 years old.
According to Thomas Carrell, MD, an orthopaedic surgeon who works at the Medical City North Hills Joint Program in North Richland Hills, Texas, “total knee replacements are one of the most common procedures performed by orthopaedic surgeons in the United States.” Carrell holds this position because he is also the medical director of the programme.
In addition to that, he notes that partial knee replacements are gaining more and more popularity.
The medial side of the knee, the lateral side of the knee, and the area directly below the kneecap are the three different compartments that make up the knee (patellofemoral). One of the compartments of the knee will be operated on during a partial knee replacement. The three parts of the knee are addressed during total knee replacement.
Is a knee replacement the best option for your condition?
If you have tried to alleviate the pain through other means, such as exercise, physical therapy, or pain medication, but have been unsuccessful, surgery might be a possibility for you. People who suffer from osteoarthritis, as well as those who have a knee deformity or injury, may fall into this category. Your healthcare professional (HCP) will discuss the pros and cons of a knee replacement with you in order to help you decide if it is the right treatment for you.
Knee replacement surgery is not the right choice for everyone. You could be disqualified from having the procedure if you have any of the following conditions, among others:
- Instances of deep vein thrombosis in addition to other blood disorders
- A persistent case of infection
- Immunosuppression caused by conditions such as chronic renal disease
- Obesity of the extremes
- Poor skin health around the joint or a lack of strength in the quadriceps muscle
Before undergoing surgery, certain patients might be required to undergo additional medical testing, such as a urologic test (for those who have a previous history of urinary tract infections) or cardiovascular tests (for people with heart disease). People who have significant dental work that needs to be done, such as tooth extractions or gum surgery, may be advised to finish these procedures before knee replacement in order to reduce the risk of infection. This is because infection can cause serious complications during the knee replacement procedure.
Instructions on how to get ready for a knee replacement
You ought to be prepared to engage in some preoperative physical therapy in order to get yourself ready for the operation. During “prehab,” you will often work on increasing the function of your knees while also preparing your home to make it simpler for you to move around in while you are recovering.
According to the findings of a study that appeared in the January 2019 issue of the Journal of Rehabilitation Medicine, patients who took part in preoperative therapy were able to leave the hospital sooner after surgery. Furthermore, these patients had a greater chance of being able to rehab independently, without the assistance of a care facility or home-health services.
Surgical procedures have advanced
Since the first knee replacement surgery was performed in 1968, a lot of progress has been made in the operation itself. Dr. Carrell notes that surgeons have been working to improve their capacity to perform minimally invasive procedures. “In the place where there used to be a long incision, there is now only a little incision.”
Knee replacements are not designed to endure indefinitely, although they do last significantly longer than they ever did. It is estimated that the knee implant will last 15 to 20 years in 85 to 90 percent of patients, which indicates that a knee replacement may at some point need to be refixed. In these circumstances, a knee revision surgery may be performed by a surgeon in order to fix the issue.
“The revision products are now as good as the first knee replacement,” says Carrell on the revision knee replacement items. “What this indicates to patients is that if they get a revision, they may be able to count on 20 or 30 more years after the procedure. In the past, the revised products wore out much more quickly than the original ones.
During the process of revision surgery, the patient’s first prosthetic implant is extracted, and a replacement is inserted in its place. In younger people who lead active lifestyles, a knee prosthetic may eventually fail owing to wear and tear, instability, or stiffness around the knee. On the other hand, a knee replacement may last for the life of an elderly patient. In extremely unusual circumstances, an infection in a knee prosthetic can need that it be replaced.
Getting well after having surgery
Following a knee replacement, a full recovery could take anywhere from six to twelve months. After surgery, you will most likely need to use a walker for a few weeks, then transition to crutches, and finally use a cane. Within the next four to eight weeks, it is highly likely that you will be able to walk unassisted. It is in your best interest not to plan on immediately getting back to the level of activity you were at before the operation.
According to Carrell, “a total knee replacement does not automatically mean that you can hop up and go.” It is true that certain projects require several months to complete. You should be able to undertake some mild exercise such as walking or other low-impact activities within six weeks, but high-impact activities may be out of the question for several months, and it may be advisable to avoid them altogether on your replacement knee.
Your surgeon may recommend blood-thinning drugs in addition to support hose or compression boots to help prevent blood clots and reduce edoema. These measures can be taken together for optimal results. Even if you are unable to walk, you will be instructed to move your feet and ankles frequently in order to stimulate blood flow, which will assist in reducing swelling and preventing blood clots.
The treatment of pain following knee replacement surgery
It is possible that you will continue to experience pain for up to three months after the surgery. Your surgeon may prescribe a mix of pain treatments, such as nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, local anaesthetics, or opioids, with the intention of decreasing your need for opioids to the greatest extent possible. Managing your pain during your recovery and physical therapy sessions will help you remain active and engaged in those sessions.
“Patients will experience less scar tissue formation if they effectively manage their pain with the guidance of their healthcare professional,” Carrell explains further. This helps prevent your knee from becoming overly stiff, which can have an influence on the range of motion you have in that joint.