What is a “knee replacement”?
Sometimes also called “resurfacing”, this operation involves the removal of the damaged, worn ends of the thigh (femur), and leg (tibia) bones that make up the knee joint, as well as the back of the kneecap (patella). The bone ends are precisely reshaped and recapped with metal surfaces, with special plastic liners added as a bearing surface that promotes low friction gliding between metal and plastic.
What are the alternatives to knee replacement surgery?
Alternatives include “living with” the arthritic knee (modifying and reducing activity, taking medicine, losing weight, and keeping the leg strong via low impact exercise), “cortisone” injections, lubricant (hyaluronate) injections, and arthroscopic “clean-out” (debridement).
When is the best time to have a knee replacement?
There is no “best time”. Most people decide to have their knees replaced when the pain becomes intolerable (e.g.- night pain or pain at rest), when their desired activities become impossible to pursue, or when medicines can no longer control the pain, after conservative, non-operative, treatments no longer help.
Do I need a blood transfusion during or after the knee replacement?
About 60% of the time, patients receive one unit of “autologous” blood, i.e.- their own blood pre-donated prior to the operation. Of course, one can also use blood from the general population, screened for infectious disease. It is recommended that one’s own blood be donated and utilized when possible, which is the usual case.
How long is the hospitalization after knee replacement?
Typically, hospital stays average 3-4 days. Rarely, patients go home in two, or stay five days.
How long do knee replacements last?
On average, if patients are not obese and do not engage in high impact exercise and activity, knee replacements last about ten years.
How do knee replacements wear out?
They usually loosen from the bone, or the plastic component wears away. This usually causes progressive pain, and on average, takes about ten years to occur.
How much pain can one expect immediately after surgery?
Pain perception is a highly variable, subjective phenomenon. On a scale of 1-10, different people will rate their pain differently, i.e.- from 1-10, with average about 5. Pain control is accomplished with narcotics, e.g.- morphine IV pumps, pain pills (narcotics and anti-inflammatories), local anaesthetic within the knee or via spinal anaesthetic techniques, and with ice.
How much stiffness can one expect after knee replacement?
Like pain, stiffness varies greatly between patients after knee replacement, and the restoration of motion occurs at different rates. Physical therapy is extremely helpful in restoring motion.
Do you have to lay on your back after surgery?
No. Many patients who have enough arthritis in the knee to undergo knee replacement, also have back arthritis as well, making some positions routinely uncomfortable. There are no restrictions to positioning in bed or out of bed after surgery. However, it is very important to elevate the leg as much as possible during inactive periods during the first 2-3 weeks post-op.
What is involved in rehabilitation after surgery?
Physical therapy (P.T.) involves techniques to 1- reduce swelling and inflammation, 2- promote range-of-motion (ROM), 3- restore strength via exercises, and 4- restore walking ability (gait). A physical therapist is extremely helpful in achieving these goals, especially for at least six weeks after surgery.
Where and when is P.T. done?
P.T. begins on the first day after the operation in the hospital. After discharge, P.T. continues either in a rehabilitation center as an inpatient, in the home by a visiting therapist, or as an outpatient in the therapist’s office.
Do I need a brace after knee replacement?
Not usually. An elastic stocking is helpful in reducing swelling, however, especially while up during the day.
Do I need crutches after a knee replacement?
Crutches are not recommended. One can usually bear full weight on the limb on the day of surgery, as pain permits. A walker, or cane, may be helpful to aid balance.
When can I drive after the operation?
Automatic transmission and left knee: as soon as one is off narcotic medication and is comfortable getting in and out of the car, and sitting in the driver’s seat.
Standard transmission and/or right knee: studies have shown that most patients regain enough function (motion and muscle control) to drive safely by 3-4 weeks after surgery.
Link to Crouse Hospital Knee Replacement Site: http://www.crouse.org/services/home.html
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