Knee Replacement Surgery

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Definition

What is Knee Replacement Surgery?

Knee replacement surgery (arthroplasty) is a routine operation that involves replacing a damaged, worn or diseased knee with an artificial joint.

The purpose of knee ligament surgery is to relieve pain and restore function in severely diseased knee joints.

When is Knee Replacement Surgery needed?

Knee replacement surgery is usually necessary when the knee joint is worn or damaged to the extent that your mobility is reduced and you experience pain even while resting.

The most common reason for knee replacement surgery is osteoarthritis. Other conditions that cause knee damage include:

  • Rheumatoid arthritis
  • Haemophilia
  • Gout
  • Disorders that cause unusual bone growth (bone dysplasias)
  • Death of bone in the knee joint following blood supply problems (avascular necrosis)
  • Knee injury
  • Knee deformity with pain and loss of cartilage

Precautions

What should you know before undergoing Knee Replacement Surgery?

Not everyone can safely undergo this procedure. A knee replacement is major surgery, so is normally only recommended if other treatments, such as physiotherapy or steroid injections, haven’t helped reduce pain or improve mobility.

You may be offered knee replacement surgery if:

  • You have severe pain, swelling and stiffness in your knee joint and your mobility is reduced
  • Your knee pain is so severe that it interferes with your quality of life and sleep
  • Everyday tasks, such as shopping or getting out of the bath, are difficult or impossible
  • You’re feeling depressed because of the pain and lack of mobility
  • You can’t work or have a normal social life

You’ll also need to be well enough to cope with both a major operation and the rehabilitation afterwards.

What are the complications and side effects?

Complications are rare but can include:

  • Stiffness of the knee
  • Infection of the wound
  • Deep infection of the joint replacement, needing further surgery
  • Unexpected bleeding into the knee joint
  • Ligament, artery or nerve damage in the area around the knee joint
  • Blood clots or deep vein thrombosis (dvt)
  • Persistent pain the in the knee
  • Fracture – a break in the bone around the knee replacement during or after the operation

In some cases, the new knee joint may not be completely stable and further surgery may be needed to correct it.

Common side effects include:

  • Pain
  • Swelling
  • Restricted range of motion
  • Numbness in the skin around the incision
  • Stiffness, particularly with excessive bending activities
  • Clicking sounds of the metal and plastic with knee bending or walking

It is important you understand the precautions and know the possible complication and side effects before having this Knee Replacement Surgery. If you have any questions, please consult with your doctor or surgeon for more information.

Process

How do I prepare for Knee Replacement Surgery?

Your doctor or anesthesiologist might advise you to stop taking certain medications and dietary supplements before your surgery. You’ll likely be instructed not to eat anything after midnight the day of your surgery.

For several weeks after the procedure, you might need to use crutches or a walker, so arrange for them before your surgery. Make sure you have a ride home from the hospital and help with everyday tasks, such as cooking, bathing and doing laundry. If you live alone, your surgeon’s staff or hospital discharge planner can suggest a temporary caretaker.

To make your home safer and easier to navigate during recovery, consider doing the following:

  • Create a living space on one floor since climbing stairs can be difficult.
  • Install safety bars or a secure handrail in your shower or bath.
  • Secure stairway handrails.
  • Get a stable chair with a firm seat cushion and back, and a footstool to elevate your leg.
  • Arrange for a toilet-seat riser with arms if you have a low toilet.
  • Get a stable bench or chair for your shower.
  • Remove loose rugs and cords.

What happens during Knee Replacement Surgery?

The surgery lasts about two hours. After that, you’ll be taken to a recovery room for one to two hours. You’ll then be moved to your hospital room, where you’ll likely stay for a couple of days.

Knee replacement surgery requires anesthesia. Your input and preference help the team decide whether to use general anesthesia, which makes you unconscious, or spinal anesthesia, which leaves you awake but unable to feel pain from your waist down.

You’ll be given an intravenous antibiotic before, during and after the procedure to help prevent post-surgical infection. You might also be given a nerve block around your knee to numb it. The numbness wears off gradually after the procedure.

Your knee will be in a bent position to expose all surfaces of the joint. After making an incision about 6 to 10 inches (15 to 25 centimeters) long, your surgeon moves aside your kneecap and cuts away the damaged joint surfaces.

After preparing the joint surfaces, the surgeon attaches the pieces of the artificial joint. Before closing the incision, he or she bends and rotates your knee, testing it to ensure proper function.

What happens after Knee Replacement Surgery?

Usually before you leave the operating room, your knee may be cradled in a passive motion machine, and medical staff will monitor the flexion (bending in) and extension (straightening out) limits of your knee.

You might begin weight-bearing therapy immediately after the operation. In addition, you will have some combination of physical and occupational therapy at the hospital. In most cases, you’ll likely be able to stand and walk, at least with the assistance of a cane or walker, before you leave the hospital.

Most of your recovery and rehabilitation will be at home after you leave the hospital. Some people need home health care or assistance.

Your doctor will most likely prescribe physical therapy at a local clinic for continued rehabilitation. The physical therapist at this clinic will suggest exercises you can do at home.

Everyone recovers a little differently following a total knee replacement. It generally takes 12 weeks to complete the rehab process and 6 months to a year to get back to full strength.

If you have any questions or concerns, please consult with your doctor or surgeon for more information.

Recovery

What should you do after Knee Replacement Surgery?

You will have stitches or staples running along your wound or a suture beneath your skin on the front of your knee. The stitches or staples will be removed several weeks after surgery. A suture beneath your skin will not require removal. Avoid soaking the wound in water until it has thoroughly sealed and dried. You may continue to bandage the wound to prevent irritation from clothing or support stockings.

Some loss of appetite is common for several weeks after surgery. A balanced diet, often with an iron supplement, is important to help your wound heal and to restore muscle strength.

Exercise is a critical component of home care, particularly during the first few weeks after surgery. You should be able to resume most normal activities of daily living within 3 to 6 weeks following surgery. Some pain with activity and at night is common for several weeks after surgery.

You will most likely be able to resume driving when your knee bends enough that you can enter and sit comfortably in your car, and when your muscle control provides adequate reaction time for braking and acceleration. Most people resume driving approximately 4 to 6 weeks after surgery.

Follow your orthopaedic surgeon’s instructions carefully to reduce the risk of blood clots developing during the first several weeks of your recovery. He or she may recommend that you continue taking the blood thinning medication you started in the hospital. Notify your doctor immediately if you develop any of the following warning signs.

Warning signs of blood clots. The warning signs of possible blood clots in your leg include:

  • Increasing pain in your calf
  • Tenderness or redness above or below your knee
  • New or increasing swelling in your calf, ankle, and foot

Warning signs of pulmonary embolism. The warning signs that a blood clot has traveled to your lung include:

  • Sudden shortness of breath
  • Sudden onset of chest pain
  • Localized chest pain with coughing

Notify your doctor immediately if you develop any of the following signs of a possible knee replacement infection:

  • Persistent fever (higher than 8 C orally)
  • Shaking chills
  • Increasing redness, tenderness, or swelling of the knee wound
  • Drainage from the knee wound
  • Increasing knee pain with both activity and rest

A fall during the first few weeks after surgery can damage your new knee and may result in a need for further surgery. Stairs are a particular hazard until your knee is strong and mobile. You should use a cane, crutches, a walker, hand rails, or have someone to help you until you have improved your balance, flexibility, and strength.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: September 12, 2018 | Last Modified: September 12, 2018

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