Artificial knees allow people to do ordinary daily activities with less pain. Knee replacement surgery cannot restore the same level of function that patients had before damage to their knee joint started.
If you suffer from the pain of advanced osteoarthritis, your doctor can help you decide if total knee replacement is the best treatment to restore your quality of life.
Am I a Candidate for Knee Replacement Surgery?
Doctors recommend joint replacement surgery when knee pain and loss of function become severe, and medicines and other treatments no longer relieve pain.
Doctors may not recommend knee replacement for people who:
- Have poor general health and may not tolerate anesthesia and surgery well
- Have an active infection or are at risk for infection
- Have osteoporosis (significant thinning of the bones)
- Have severe weakness of the quadriceps muscles at the front of the thigh
- Have a knee that appears to bend backward when the knee is fully extended (genu recurvatum), if this condition is due to muscle weakness or paralysis
- Are severely overweight (replacement joints may be more likely to fail in people who are very overweight)
Knee replacements are not ideal for people who are younger and/or do strenuous work. An artificial knee joint is more likely to wear out in these patients than in an older or less active person. If you are a younger patient, you may be a candidate for MAKOplasty® Partial Knee Resurfacing.
What Happens During Knee Replacement Surgery?
During knee replacement surgery, your orthopaedic surgeon replaces damaged bone and cartilage in a step-by-step process:
- Surgeons often replace the entire surface at the ends of the thigh and lower leg bones. They cap the end of these damaged bones, as well as the kneecap, with artificial surfaces lined with metal and plastic. Doctors usually secure knee joint components to the bones with cement.
- Doctors remove the damaged cartilage and replace it with new joint surfaces.
Most patients are under general anesthesia for joint replacement surgeries. That means you'll be unconscious during surgery. Regional anesthesia – which only numbs the knee area and keeps you awake, but sleepy – may be an option for some patients.
Your doctor may recommend that you take antibiotics before and after the surgery to reduce the risk of infection. Major dental work should be done before the surgery because infections can spread from the mouth to the artificial joint.
What To Expect After Surgery
When you wake up from surgery, you may have:
- A bandage on your knee and probably a drain to collect fluid and keep it from building up around your joint
- A catheter connected to your bladder, so you don't have to get out of bed to urinate
- A compression pump or compression stocking on your leg to keep the blood circulating and help prevent blood clots
- A continuous passive motion machine (CPM) cradling your leg to keep your knee flexible. The machine is fitted to your leg length and joint position.
- An IV to administer antibiotics for about a day after surgery
- Medications to control pain
- Medications to prevent blood clots (anticoagulants)
Most people go home a few days to a week after surgery. Your doctor may want to see you for regular visits for several months or more to monitor your knee replacement.
Rehabilitation after Knee Surgery
Rehabilitation (rehab) after a knee replacement is intensive. You will work with a physical therapist during your hospital stay, and continue with an exercise program after you return home. Some patients may need to go to a specialized rehab center for more treatment. Total rehab after surgery will take several months.
The main goal of rehab is to allow you to bend your knee at least 90 degrees—enough to do daily activities, such as walking, climbing stairs, sitting in and getting up from chairs, and getting in and out of a car. Most people can bend more, but it depends on how much bend you had before surgery.
Most people start to walk with a walker or crutches the day after surgery and can bear weight on the knee if it is comfortable. After you go home, your doctor may recommend:
- Taking a short walk several times each day
- Riding a stationary bicycle to strengthen your leg muscles and improve your knee bending
Living with a Knee Replacement
Most people have much less pain after knee replacement surgery and are able to do many of their daily activities more easily. Here’s what you can expect:
- The knee will not bend as far as it did before you developed knee problems, but the surgery will allow you to stand and walk for longer periods without pain.
- You may be allowed to resume activities such as golfing, riding a bike, swimming, walking for exercise, dancing, or cross-country skiing (if you did these activities before surgery).
- Your doctor may discourage you from running, playing tennis, squatting, and doing other things that put a lot of stress on the joint.
Controlling your weight will help your new knee joint last longer. Learn more about Weight Management.