Knee Replacement Procedure
Overview
Knee replacement, also called knee arthroplasty, involves surgeons removing damaged sections of the knee joint and replacing them with artificial parts made from metal and plastic. This procedure can take the form of a total knee replacement or a partial knee replacement, depending on the amount of joint damage.
Doctors use X-rays to check how much the knee has been affected and study factors like knee stability, movement, and overall strength. A person’s age, weight, activity level, and the specific shape and condition of the knee help determine the right type of joint replacement.
Reasons for Having the Procedure
Doctors usually recommend knee replacement to help ease ongoing pain and stiffness caused by arthritis, especially osteoarthritis. When cartilage wears away, the bones in the knee can rub together, leading to discomfort and less movement.
This often causes trouble with daily actions like walking, going up stairs, and standing up from a chair. Main conditions leading to knee replacement:
- Osteoarthritis: The most common cause, where the cartilage in the knee wears down.
- Other Types of Arthritis: Including rheumatoid and post-traumatic arthritis.
- Injuries: Severe damage to the knee, such as ligament injuries, can result in long-term pain or instability.
Parts involved in knee replacement surgery:
| Part of Knee | Role in Surgery |
|---|---|
| Tibia (shinbone) | Surgeon may reshape ends. |
| Patella (kneecap) | Sometimes resurfaced. |
| Ligaments | May need added support. |
If only one area of the knee is affected, a partial replacement is possible. For more serious damage, the surgeon performs a total knee replacement. Some patients need additional support from specialized implants if their ligaments cannot hold the joint steady on their own.
Possible Side Effects
Knee replacement surgery carries some risks. Blood clots can form in the leg and cause pain or swelling. If a clot moves to the lungs, it can be very serious. Doctors often prescribe blood-thinning medicine to help lower this risk. Infection may occur at the incision site or deeper in the joint.
Infections sometimes require more treatment, like antibiotics or another surgery. Other risks include nerve damage, which may cause numbness or muscle weakness. Rarely, a stroke can also happen after surgery. Joint implants can sometimes wear out and might need to be replaced with another surgery.
Table: Common Risks After Knee Replacement
| Risk | What Can Happen | Possible Action |
|---|---|---|
| Blood Clots | Leg pain, swelling, lung issues | Use blood thinners |
| Infection | Redness, fever, pain | Antibiotics, surgery |
| Nerve Damage | Numbness, weakness | Monitoring, therapy |
| Stroke | Sudden weakness or confusion | Emergency treatment |
| Implant Wear | Loosening, pain | Revision surgery |
Getting Ready for Surgery
Diet and Medications
The medical team often advises patients to pause certain medicines or supplements before surgery. Patients may need to stop nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, and aspirin about a week before the procedure.
They are usually told not to eat or drink after midnight on the day of their operation, especially when general anesthesia is used. This reduces possible risks during surgery.
Tip: Ask your orthopaedic surgeon or care team if you need special instructions about your usual medicine or food, especially if imaging like x-rays or magnetic resonance imaging (MRI) is scheduled before surgery.
Setting Up for Healing at Home
Planning for recovery is important for safety and comfort. Arrange for someone to take you home and help with daily routines like bathing, cooking, and laundry. Prepare crutches or a walker in advance, as these may be needed for several weeks.
To improve Home Safety
- Move living spaces to one floor.
- Add sturdy handrails or safety bars in bathrooms and stairways.
- Use a firm, stable chair with a cushion and footstool for leg support.
- Get a toilet seat riser and shower bench if needed.
- Remove loose rugs, cords, and clutter to prevent falls.
What You Can Expect
What Happens in the Operating Room
Before surgery begins, the patient puts on a hospital gown and receives anesthesia. Anesthesia options include a spinal block to numb the lower body or a general anesthetic for deep sleep. Pain relief may also come from medicine given around nerves or the knee joint.
The operation generally takes between 1 and 2 hours. The surgeon makes a cut over the front of the knee and removes damaged parts of bone and cartilage, but keeps healthy bone. After removal, the surgeon puts the new knee parts in place, connecting them to the thighbone, shinbone, and kneecap.
What Happens After Surgery
After the procedure, recovery starts in a special area where nurses monitor the patient. How long someone stays in the hospital can differ. Some people leave the same day, while others may need more time for observation.
A hospital stay may last just a few hours to several days. Because knee surgery increases the risk of blood clots, steps are taken to help prevent them. These include:
| Prevention Method | Purpose |
|---|---|
| Early movement | Patients get up and walk with a walker or crutches soon after surgery. |
| Compression stockings/air sleeves | These help keep blood moving and reduce clot risk. |
| Blood thinners | Doctors may prescribe medicines for several weeks. |
Patients do simple breathing exercises to reduce lung problems. Gradually increasing activity helps start knee rehabilitation and reduces complications. Physical therapists guide people on how to move, climb stairs, and perform exercises to strengthen the knee.
Many patients continue with physical therapy in their own homes or at a rehabilitation or physical therapy center. Occupational therapy may be suggested, especially if extra support is needed for daily activities.
Findings
Most individuals experience less pain and improved knee function following knee replacement. Many can expect their knee implant to last between 15 and 20 years before a revision knee replacement might be needed. Common benefits include:
- Pain relief
- Increased mobility
- Better quality of life
Many people return to low-impact activities—such as walking, swimming, biking, or golfing—after recovery. However, activities that involve running, jumping, or strong physical contact are usually discouraged to help protect the artificial joint and avoid the need for revision surgery.
