If your knees are injured, you may find yourself giving up activities you love, like playing on the floor with your children. Climbing stairs or even standing up may have become an ordeal. The knee pain from a past injury, or the gradual wear and tear of arthritis, can keep you on the sidelines and derail your active lifestyle.
Orthopedic surgeons treat the knee more than any other joint. In fact, knees are among the most easily injured joints. As the largest joints in your body, they take a good deal of abuse. Walking, running, and bicycling can take a toll on your knees. Sports such as football, basketball, baseball and soccer can be particularly tough on knees as well.
The Specialists at Huntington Orthopedics are dedicated to returning people with knee pain to their active lives. We work with you hands-on to restore your quality of life, managing medications and physical therapy, and offering the most advanced minimally invasive surgery.
You may be treated non-surgically. However, if medications, changing your activity level, and using walking supports are no longer helpful, you may want to consider partial or total knee replacement surgery. By resurfacing your knee’s damaged and worn surfaces, total knee replacement surgery can relieve your pain, correct your leg deformity and help you resume your normal activities. You and your orthopedic surgeon would make a joint decision on whether a knee replacement would best fit your needs.
Knee Arthroplasty (Knee Replacement)
Knee Arthroplasty is commonly performed to relieve pain and disability. It is recommended when the pain of meniscus tears, osteoarthritis, cartilage defects, and ligament tears becomes too debilitating.
Knee Arthroplasty is major surgery. Prior to surgery, the following pre-operative tests may be performed.
A complete blood count, electrolytes, APTT and PT to measure blood clotting, chest X-rays, ECG, and blood cross-matching for possible transfusion.
Precise X-rays of the affected knee are needed to measure the size of components which will be needed.
Medications such as warfarin and aspirin will be stopped some days before surgery to reduce the amount of bleeding. Patients may be admitted on the day of surgery if the pre-op work-up is done in the pre-anesthetic clinic or may come into hospital one or more days before surgery.
Crutches or walkers are required until the quadriceps muscle has healed and recovered its strength. Continuous Passive Motion or CPM is commonly used.
Post operative hospitalization averages one day to a week. This depends on the health status of the patient and the amount of support available outside the hospital setting.
The full range of motion is recovered over the first two weeks. At 6 weeks people have usually progressed to full weight bearing with a cane. Complete recovery from the operation involving return to full normal function may take three months and some patients notice a gradual improvement lasting many months longer than that.
Partial Knee Resurfacing or Replacement
As an alternative to total knee replacement surgery, (practice) offers partial knee resurfacing. The surgeon targets the diseased area of the knee without affecting the surrounding normal, healthy cartilage. Through a tiny incision of only 2-3 inches, the diseased part of the knee is removed and replaced with orthopedic implants.
The knee is generally divided into three compartments including the medial (inside), lateral (outside), and patellofemoral (joint between kneecap and thighbone). Most patients with severe arthritis have significant wear in two or more compartments. For them, total knee replacement is the best treatment. The rest – about 10 to 30 percent of candidates -- have wear confined mostly to one compartment, especially the media. These may be candidates for partial knee replacement.
Partial knee replacements have 2-3”incisions compared to 8-9” incisions for total knee replacements. Other advantages include easier post -op rehabilitation, shorter hospital stays, less blood loss, lower risks of infection, stiffness, and blood clots.
Most patients return to normal activities within six to eight weeks. Recovery periods vary by the extent of the surgery. The doctor may send you home with orthopedic braces that you will wear until you have fully healed.
Total Knee Replacement
When damage to the knee is more extensive, it may be necessary to replace the entire knee. During total knee replacement surgery, damaged bone and cartilage are removed and replaced with a plastic and metal prosthesis. Having one of the best orthopedic surgery teams on your side helps to ensure a successful surgery.
Minimally invasive procedures have been developed in total knee replacement (TKR) that do not require dramatic cuts to and through the quadriceps femoris muscle. This reduces post-operative pain and disability. Less invasive procedures are done by using gender-specific or patient-specific knee implants that fit the knee better and more precisely, and have better long-term outcomes.
Knee Replacement Recovery
After Total Knee Replacement, the knee may not recover its normal range of motion from 0 - 135 degrees. This depends to some extent on the knee’s functioning prior to surgery. Most patients will achieve 0 - 110 degrees of motion, but stiffness of the joint can occur. Some situations call for manipulation of the knee under anesthetic to improve post operative flexibility. Manufacturers have designed high-flex knees that offer a greater range of motion.
In rare cases after surgery, some people find their kneecap is unstable. It may dislocate to the outer side of the knee. This painful condition generally requires another surgery to realign the kneecap.
Today, there have been considerable improvements in medical technologies. The risk of implant components loosening over time as a result of wear has fallen dramatically. One implant manufacturer claims to have reduced this risk of wear by 79% in fixed-bearing knees. Another claims a reduction in risk of wear by 94% in mobile-bearing (rotating platform) knees. Knee replacement implants can last up to 20 years in many patients.
Recovering from Total Knee Replacement Surgery
According to the American Academy of Orthopedic Surgeons, blood clots in the leg veins are the most common complications of knee replacement surgery.
Your orthopedic surgeon will outline a prevention program, which may include periodic elevation of your legs, lower leg exercises to increase circulation, support stockings and medication to thin your blood.
Periprosthetic fractures are becoming more frequent with the aging patient population and can occur during or after surgery.
How long does knee replacement surgery take?
Your orthopedic surgeon will remove the damaged cartilage and bone and then position new metal and plastic joint surfaces to restore the alignment and function of your knee. In all, it takes about two hours to complete knee replacement surgery.