Knee Replacement (Knee Arthroplasty) Surgery

Overview

A knee replacement is an orthopedic surgical procedure where a damaged or diseased knee joint is replaced with an artificial joint. The knee is responsible for providing motion where the lower leg meets the thigh.

Knee replacement candidates

The most common reason why patients need a knee replacement is to relieve chronic pain and disability in the knee caused by osteoarthritis. If nonsurgical therapies such as physical therapy, cortisone injections, losing weight, and pain medication are not providing relief, you may be a candidate for a knee replacement.

Other reasons why you may need a knee replacement include:

• You have rheumatoid arthritis.
• You have arthritis as a result of trauma to the knee.
• You have had a knee fracture, torn knee cartilage, or torn knee ligaments that damage the knee joint.

Patients over 200 pounds are not ideal candidates for knee replacement due to the excess weight on the knee that could cause it to dislocate.

Knee replacement risks

Knee surgery is a complex procedure where complications can occur. Complications may include:

• Infections.
• Bleeding.
• Blood clots.
• Pain and swelling.
• Breathing problems.
• Nerve and artery damage.
• Allergic reaction.
• Implant failure.

Knee replacement surgery preparations

Most patients must wait six to 12 weeks to have knee replacement surgery. There are a variety of things you can do during this period to ensure you have a successful surgery and recover as quickly as possible, including:

• Pre-surgical physical therapy (PT). PT before surgery can help you strengthen the muscles around the knee to reduce pain and improve knee function after surgery.
• Stop taking (or decrease medications two weeks before surgery. Follow your doctor's instructions on what medications to stop taking prior to surgery. Medications such as aspirin, Aleve, and Advil may make it more challenging for blood to clot. Steroids may suppress the immune system, making you more susceptible to infection. Opioid pain medications decrease tolerance to pain medication.
• Stop smoking or using other tobacco products.
• Ensure your surgeon knows about all other medical conditions to determine if you are healthy enough to undergo surgery.
• Eliminate alcohol use.
• Report any illnesses such as fever or flu you acquire in the two weeks before surgery.

Knee replacement surgery testing

Your doctor will order:

• Blood and urine tests to evaluate your liver and kidney function as well as look for any signs of anemia.
• Chest X-rays or EKG to ensure you have healthy lungs and heart.

Knee replacement surgery expectations

Some patients can have knee replacement surgery as an outpatient procedure without needing a hospital stay, while others may need to stay in the hospital between one to four days.

Before surgery, you will likely need an intravenous line to give you fluids or medications.

Your care team will give you general anesthesia, which will put you to sleep, or spinal anesthesia, which will numb your body from the waist down.

Your orthopedic surgeon will decide if you should have open surgery or minimally invasive knee replacement surgery.

• In open surgery, your surgeon will make a large incision in the front of the knee. The surgeon will take out the damaged bone or tissue, resurface the thigh bone and shin next to the damaged area, and implant the artificial knee.
• Minimally invasive surgery. During minimally invasive knee replacement surgery, your surgeon will make a smaller cut and use arthroscopic equipment to repair the damage and rebuild the joint. Young, thin, and healthy patients are typical candidates for this type of ankle replacement.

Knee replacement surgery duration

Knee replacement surgery takes approximately one to three hours. After surgery, you will be taken to the recovery room to be monitored. When you are in stable condition, you are moved to a hospital room.

Physical therapy is an essential part of the recovery process. For optimal success, you must be fully engaged in rehab. If the surgery went according to plan, you could begin physical therapy 48 hours after surgery.