More than 400,000 people worldwide have a knee joint replacement surgery each year. The average age of those undergoing this procedure is 65 to 70, but it is not uncommon for both older and younger adults to have it. Understand that 90 to 95 percent of people who have this surgery experience significant improvement in their knee pain and function.
Significance
Having total knee replacement surgery, also called total knee arthroplasty, is a big decision. While this surgery has a good track record, it should not be undertaken lightly. People generally have the surgery to address arthritic changes in their knee joints that either cause debilitating pain or a significant limitation in their daily activities.
Preparing for Surgery
In addition to lab tests to verify your general health, your doctor may prescribe physical therapy or an exercise program to help you prepare for surgery. These exercises are designed to strengthen the muscles around your knee, which will ease your post-op recovery. If you are overweight, try to lose a few pounds. Excess weight may not exclude you as a candidate for a knee replacement, but it could make the surgery and post-op recovery more difficult. People who are overweight are more at risk for complications after the surgery, such as blood clots and infection.
Risks
All surgeries carry risks, but only about 2 percent of people having a knee replacement will have a serious complication from the surgery. These include blood clots, infection, stroke, heart attack and nerve damage.
What Happens During the Operation
During a total knee replacement operation, the orthopedic surgeon removes the damaged bone and cartilage from your thigh and shin bones at the knee and replaces them with metal and plastic components. Sometimes the surgeon will clean off the back of the patella, or knee cap, and place a plastic "button" there, so the patella can glide more freely over the joint.
Rehab in the Hospital
Rehab for your total knee arthroplasty begins immediately. A physical therapist will have you start walking right away, either with a walker or crutches. She will also instruct you in exercises to help you regain strength and range of motion in your knee as quickly as possible. Ice packs or cooling pads will help keep knee swelling down, and your doctor may have you use a continuous passive motion (CPM) machine to help you maintain your range of motion. Talk to your doctor about how best to manage your pain, an important aspect of your recovery.
Rehab When You Leave the Hospital
Some people go to a skilled nursing facility for a short time after knee replacement surgery, but if you can walk safely with crutches or a walker and have someone who can stay with you all the time, you can probably go right home. A physical therapist may come to your home to continue your rehabilitation program, or you may go to a physical therapy clinic in your community. In either case, the doctor and therapist collaborate to advance your rehab program, including choosing the right time for you to discontinue use of your crutches, increase your activity and do water therapy or bathe. (Showers are usually allowed soon after the surgery, but soaking the incisional area is not usually allowed for several weeks.) Following your rehabilitation program will be the shortest, safest route back to your daily routine and significantly increase the chance that you'll be happy you chose to have the surgery.
Tags: knee replacement, total knee, replacement surgery, your doctor, after surgery, blood clots, blood clots infection