Knee Replacement

This content is for informational purposes only and is not intended to provide medical advice or to treat, diagnose, cure or prevent any disease or condition. Always seek the advice of your healthcare provider.

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Knee replacement surgery is for individuals with severe knee damage, and is performed to relieve pain and restore function to the joint.

In ​total knee replacement​ (also known as ​knee arthroplasty​), the surgeon removes the damaged cartilage and bone, and replaces them with a new, artificial joint called a prosthesis. The prosthesis is made of high-grade metal and plastic parts. In ​partial knee replacement​, in which the damage of the joint is confined to one area, the surgeon only replaces that part of the knee joint.

Risks and Complications

While the complication rate associated with knee replacement surgery is very low, there are still risks that should be considered. Complications can include the following, and should be discussed with your doctor or surgeon before deciding to have surgery:

  • Blood Clots
  • Infection
  • Blood Vessel or Nerve Damage
  • Continued Pain
  • Loosening of Prosthesis
  • Stiffness
  • Anesthesia Risks
  • Total Knee Replacement

    The process of a total knee replacement, typically includes the following steps:
    1) ​Incision:​ The surgeon makes an incision on the front of the knee to access the knee joint.

    2) ​Prepare and Shape the Bones:​ Damaged cartilage at the end of the femur (thigh bone) and tibia (shin bone) are removed. The femur and tibia are cut and shaped to make room for the placement of the prosthesis. If the patella (the knee cap) is damaged, the undersurface may be cut and replaced with a type of plastic button.

    3) ​Prosthesis Placement:​ The prosthesis replaces the cartilage and bone that’s been removed, and is positioned to fit the joint accurately. This includes the plastic ‘spacer’ which is inserted between the 2 metal components on the femur and tibia. This spacer creates a smooth surface for the metal prosthesis to glide.

    4) ​Repair the muscles and tendons around the new joint and close the incision with stitches or surgical staples.

    After Surgery

    Knee replacement surgery usually requires a hospital stay of several days. Immediately after surgery you’re taken to a recovery room for observation. Here they monitor your blood pressure, pulse, breathing, and your alertness once you wake up from the anesthesia. Then you’re moved to a hospital room in which you’re monitored, given pain medication, given antibiotics to help prevent infection, and given instructions on preventative measures for blood clots. Preventative measures to prevent blood clots and decrease swelling include being given blood thinners and compression socks or ‘boots’, as well as instructions for moving your foot and ankle to encourage blood flow.

    A physical therapist will guide you on exercises to strengthen your knee, aid in recovery, and restore knee movement so you can slowly resume daily activities. Your leg may be placed in a continuous passive motion (CPM) exercise machine while you’re in bed. A CPM will slowly move your knee to help restore movement. This device also elevates your leg, which can help decrease swelling.

    One effect from the combination of anesthesia, pain medication and sitting in bed for prolonged periods can be shallow breathing and a susceptibility to pneumonia. To prevent pneumonia, you may be given a simple apparatus called a spirometer, which helps you to take deep breaths.

    Prognosis (Outlook)

    The prognosis after having knee replacement surgery is usually excellent. For most people, it relieves pain and restores function. While the full recovery can take several months to a year, most people don’t need help walking after a full recovery. The prosthesis can last about 10 to​ 15 years, or even longer.

    Preparing Your Home

    Making modifications to your home will help you in your recovery. Adjustments to your home will make it safer and easier for you during your road to recovery.

  • Create a one-floor living space. ​Climbing stairs can be difficult (and may be prohibited by your doctor) so if possible, have your bed and bathroom necessities on the first floor. Set up a stable chair with a firm back for you to sit, and use a footstool to elevate your leg.
  • Make items accessible.​ You can purchase a ‘reaching stick’ to help grab things or pick things up, but you may also want to put your daily use items within reach ahead of time. You’ll want to avoid getting on your tiptoes or bending down to reach things. Consider buying a fanny pack so that you have items like your cell phone, medications, and paper and pen on you at all times.
  • Safety-proof your home.​ Remember that moving around will be a challenge at first and that you may be using a cane, crutches or a walker. Remove all loose carpets and electrical cords that can cause you to trip and fall, place a non-skid mat in your bathroom, use night lights in the hallways and rooms for nighttime, and take note of uneven surfaces.
  • Use assistive devices.​ These can help with mobility and may include canes, crutches or walkers; raised toilet seat; shower bench or chair; safety handrails; long-handle shoehorn; dressing stick; etc.
  • Plan for a caregiver to help you. ​The first 1 to 2 weeks after surgery you will likely need assistance with bathing, using the toilet, going for follow-up appointments, running errands, etc. If you don’t have someone to help take care of you, ask your healthcare provider about a trained caregiver who can come assist you.
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