Over a period of time, due to advancing age or injury, the knees lose their flexibility. As a result, it becomes painful for people to bend their knees due to accompanying inflammation and pain. The mobility becomes further restricted and the pain increases when the cartilage between the two knees wears out with age.
The bad condition of the knee joint and the surrounding cartilage make it difficult for people to move, thus hindering their performance in conducting daily activities. If nothing is done to rectify the condition, the situation only worsens, becoming more painful and difficult.
In such cases, surgery is often recommended as the first line of treatment, most commonly after there is no relief from pain from medications and physiotherapy. It is estimated that more than 90 percent of the patients benefit from the procedure.
During knee replacement, the knee joints that get damaged because of injury or osteoarthritis are replaced with mechanical implants. The doctors may decide to conduct a total knee replacement or partial knee replacement, depending on the condition of the knee.
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Patients suffering from osteoarthritis of the knee are often surrounded by a number of questions, especially related to whether they should undergo knee replacement or not or if there is any other alternative line of treatment. Some of these common questions that a patient advised to undergo knee replacement typically have are discussed below.
Question 1: Is total knee replacement the only solution to get relief from osteoarthritis pain?
No, total knee replacement is not the only option to get relief from pain. However, 90 percent of all knee-related surgeries include total knee replacement. The other options that you may opt for include partial knee replacement, minimally invasive knee replacement, physical therapy and pain control using drugs and ointments.
In case of partial knee replacement, the surgeon just cuts out the part of the knee damaged and replaced it with mechanical implants. The rest of the knee is left in its natural form. It requires smaller incisions and recovery is quick.
However, this minimally invasive form of surgery is performed only by a handful of specialized doctors. In addition, there is a risk that the osteoarthritis may return in the part of the knee, left by the doctors in its natural form. This may require further surgical intervention in the future.
On the other hand, minimally invasive form of total knee replacement is a newer form of technique that allows surgeons to replace knees without making a larger incision. It results in less damage to the tissues, minimal scarring and quicker recovery time. However, the long-term benefits of this technique are still being researched.
Osteoarthritis patients are often prescribed medications, physical therapy and exercises at the primary level. Knee replacement is recommended only when there is no relief from these techniques or when the movement is totally restricted because of severe pain and inflammation.
Question 2: What are the complications associated with the procedure?
Knee replacement surgery is considered as a safe procedure. Only a fraction of patients experience complications after knee replacement. One of the most common surgical complication is the occurrence of an infection post surgery. However, so far it has affected only 2 percent of the patients.
Other complications may include blood clots, damage to the blood vessels and surrounding tissue, recurring pain and rejection of the implant or a defect in it.
Question 3: How much time does it take to recover?
Despite hospitals and surgeons claiming that an osteoarthritis patient is able to walk normally within a week of operation, it may take several weeks for the patients to recover from the surgery.
Soon after total knee replacement, patients are advised to undergo a combination of physical and occupational therapy at the hospital itself. The therapy may continue for days after the patient is discharged from the hospital. Typically, a total knee replacement patient is required to stay in the hospital for three to five days after the surgery.
The patients start to walk or stand, with the help of a walker or without support, when they leave the hospital. The rehabilitation and recovery continues for at least two months after the surgery. Along with occupational and physical therapy, some set of exercises is often recommended to be performed at home for quick recovery.
By the end of eight weeks, the patients are expected to stand and walk properly without any support and resume doing household work. However, recovery could be slow in some patients. Patients are often asked to avoid squatting and complete bending of the knee.
Question 4: What exactly happens during knee replacement surgery?
During the knee replacement surgery, the surgeon encases the shin bone with plastic and the thigh bone with a metal casing. All this is done under the influence of general anesthesia. Prosthetic implant is then used to replace the worn out, irregular surface of the knee bone.
The surface under the knee cap is also replaced with plastic. This is done to ensure smoother movement of the joints after the surgery and to reduce pain. Overall, the surgery includes removal of some natural cartilage and bone.
Either cement or some other material is used to join the artificial parts or implants with the shin bone, thigh bone and knee cap. After setting, the artificial parts form joints that depend on the surrounding ligaments and muscles for support and proper functioning.
Question 5: Am I eligible for knee replacement?
You are eligible for knee replacement surgery if you are above 50 years of age and suffer from severe arthritis of the knee. The conditions should be so severe and painful that makes it impossible for you to stand or walk properly or hinder with the daily routine of activities.
Patients with damaged knees due to an accident, with no gap between the knees and those with severely restricted movement are perfect candidates for this type of surgery.
Question 6: Is it a safe procedure?
Knee replacement has been there as an option for more than four decades now. It is a safe procedure, however, like all other surgeries, it has risks too. Apart from blood clots, infection and bleeding, there are certain things that the surgeon should pay particular attention to while performing the surgery.
Some of these concerns include:
- Pieces of bone marrow or fat entering the bloodstream during the surgery pose a serious risk. These tiny pieces can enter other organs such as lungs and cause serious problems.
- Pressing of the nerves may cause numbness.
- The artificial parts or implants can break inside the body or become loose.
- Other bones may also break if pressurized during surgery.
All these complications during knee replacement may result in longer hospital stay and recovery time. The patient may even lose his or her life if proper care is not taken to limit the infection and bleeding or to stop the formation and circulation of blood clots.
Question 7: What happens after knee join replacement?
You are expected to take occupational and physical therapy after knee replacement. In addition, you should completely avoid twisting or pivoting the leg in question for at least six weeks. Kneeling and squatting should also be avoided and you should try to keep your knee as straight as possible when lying down in bed.
You should follow all guidelines to reduce knee replacement recovery time. Remember, not following any of the recommended guidelines may increase your recovery time and can also lead to dislocation of the joint.
You are also required to avoid stair climbing, playing with the pets and falls during the recovery period. The doctor must be consulted before resuming back to normal routine activities, including sexual activity, driving, exercising and gym.
Question 8: How long does the new joint last?
Knee replacement surgery started to take place during the 1970s. Around that time, the average year of the replaced joint was considered to be around 10 years.
However, with advances in medical sciences, artificial joints with different average lifespans are now available. More than 80 percent of the joints replaced nowadays have a lifespan of more than 20 years. This has been made possible by improvements in the artificial joint material and the material used to join them with the bones.
The cost of knee replacement surgery depends on the life of the implant, the duration of stay at the hospital, the fees of the doctor, the country and the type of hospital you are deciding to get operated in.