Understanding Knee Replacement Surgery

Before delving into the intricacies of what one wishes they knew before undergoing a knee replacement surgery, it's crucial to first understand what this procedure entails and its prevalence.

What is Knee Replacement Surgery?

Knee replacement surgery, also known as knee arthroplasty, is a medical procedure performed to relieve pain and restore function in severely diseased knee joints. During this surgery, a surgeon cuts away damaged bone and cartilage from the thighbone, shinbone, and kneecap, replacing it with an artificial joint made of metal alloys, high-grade plastics, and polymers.

This procedure is often recommended for individuals experiencing severe knee pain or stiffness that limits daily activities, moderate to severe knee pain while resting, chronic knee inflammation, and failure to obtain relief from other treatments.

Knee replacement surgery is generally considered a safe procedure with complications being very rare. Studies show that over 95% of patients recover from knee replacement surgery without complications. Additionally, knee implants are built to be long-lasting, with many patients experiencing knee replacements that last 20 years or longer [1].

Prevalence of Knee Replacement Surgeries

Knee replacements are one of the most common types of arthroplasties, with surgeons in the U.S. performing more than 850,000 knee replacements each year, as reported by Cleveland Clinic. The American Academy of Orthopedic Surgeons states that over 790,000 knee replacement surgeries are performed in the United States every year.

A recent study showed that the 10-year implant survival rate for knee replacements is more than 96 percent, with a 20-year survival rate of roughly 90 percent. Hence, most people won't need a second knee replacement surgery [1].

In summary, knee replacement surgery is a prevalent and generally safe procedure that can significantly improve the quality of life for individuals suffering from severe knee pain or disability. With a better understanding of this procedure, patients can make informed decisions and prepare effectively for their surgery.

Preparing for Knee Replacement Surgery

Preparation is key when it comes to knee replacement surgery. It involves not only physical readiness, but also preparing your home and support system to aid in a smooth recovery process.

Physical Preparation and Strengthening

A crucial aspect of what individuals wish they knew before knee replacement surgery is the importance of physical preparation. Strengthening and conditioning your body through exercises can aid recovery post-surgery. For instance, losing one pound of weight can relieve four pounds of pressure on your knees. Lower impact exercises like yoga, biking, or swimming can be effective in this context.

Patients are also advised to cut back on substances like alcohol and tobacco as they can complicate surgery and hinder recovery. For instance, smoking can increase the risk of developing blood clots and other complications post-surgery [2].

A week before knee replacement surgery, patients are advised to attend a pre-op appointment to ensure they are physically and mentally ready for the surgery. This appointment involves checking for underlying conditions and adjusting medications as needed.

Home and Support System Preparation

Preparing your home and support system is an essential step towards a successful knee replacement surgery and recovery. This includes securing useful devices like a reacher, sock aid, or long-handled sponge, and implementing safety measures around the house to help prevent accidents during the rehabilitation period.

Patients are recommended to have a family member or friend available to assist them 24 hours a day for the first week post-surgery. Organizing additional support from friends, family, or neighbors can also be beneficial. Planning for meals in advance and stocking up on prepared foods can alleviate the workload on caregivers.

Before knee replacement surgery, patients will be provided with antibacterial soap and detailed instructions on when and how to use it. This reduces the risk of infection.

Patients are also advised to resolve any significant dental conditions before knee replacement surgery, as dental procedures can potentially cause an infection in the artificial joint.

Finally, arranging for a ride home post-surgery is crucial. Patients typically get a ride from a loved one, ensuring a comfortable and safe journey home after the procedure.

Taking the time to adequately prepare for knee replacement surgery can significantly impact the recovery process. Being proactive and planning ahead can lead to a smoother transition from the hospital to home, and ultimately a successful rehabilitation.

Risks and Complications of Knee Replacement

While knee replacement surgery can dramatically improve the quality of life for individuals with severe knee pain, it is not without its risks and potential complications. Understanding these risks is a key piece of what patients wish they knew before knee replacement surgery.

Short-Term Surgical Risks

In the immediate aftermath of knee replacement surgery, several complications can arise. However, these are generally rare. For instance, in fewer than 2 percent of cases, severe complications such as infection occur [4].

During a hospital stay post-surgery, complications are not very common. Healthline's analysis showed that 4.5 percent of people under 65 experienced complications, with the risk being more than double for older adults.

In rare cases, approximately 1.8 percent of individuals reported an infection within 90 days after surgery.

Damage to nerves, blood vessels, or ligaments around the knee joint during surgery are also potential risks, which can be addressed either during the surgery or through postoperative healing.

Long-Term Complications

While knee replacement surgery is generally a safe procedure with complications being very rare, there are some long-term complications to be aware of.

One of the most common long-term complications is the wear and loosening of the knee replacement implant. This affects about 6 percent of individuals after 5 years and 12 percent after 10 years. Despite this, more than 82 percent of replacement knee joints are still operational after 25 years.

Revision surgery is another potential long-term complication. The average rate of revision surgery within 90 days post knee replacement is 0.2 percent, but this figure rises to 3.7 percent within 18 months [4].

While complications are uncommon, some individuals may experience ongoing issues with their new knee post-surgery. Physiotherapy, exercises, or even another replacement later in life might be necessary in these cases. However, most knee replacements last for around 20 years or more.

In conclusion, while knee replacement surgery has its risks, the vast majority of patients recover without any complications. As with any medical procedure, it's crucial to discuss these potential risks and complications with a healthcare provider to make an informed decision about knee replacement surgery.

Recovery from Knee Replacement Surgery

Understanding the recovery process from knee replacement surgery is an essential part of preparing for the procedure. It provides insight into what one can expect in the immediate post-surgery period and during long-term recovery and rehabilitation.

Immediate Post-Surgery Period

After undergoing knee replacement surgery, the recovery process begins immediately. Physical therapy is a crucial part of this process and starts as soon as the patient gets out of bed. This therapy focuses on maintaining range of motion, rebuilding muscle strength, and gradually transitioning to therapy at a clinic or virtually [6].

In this period, patients may face knee pain, swelling, and stiffening. While uncomfortable, these symptoms generally improve within ten weeks but may take up to a year to fully resolve [7].

Patients are advised to strictly adhere to a list of restrictions provided by their knee replacement specialist post-surgery. These restrictions include avoiding activities like kneeling, squatting, and driving that stress the knee joint. However, these restrictions are gradually relaxed as the patient's health status improves within the first five weeks.

Long-Term Recovery and Rehabilitation

Long-term recovery from knee replacement surgery is a continuous process. Most patients are able to walk without a walker or cane approximately six weeks after the surgery. However, the actual recovery period can vary based on individual factors such as overall health and fitness level before the operation [6].

As recovery progresses, patients can return to a fully active lifestyle, progressively resuming activities like walking, biking, golf, skiing, and tennis. The wound healing process is aided by less invasive procedures, resulting in smaller incisions that are aesthetically pleasing and heal better.

In conclusion, the recovery from knee replacement surgery is a journey that requires patience, adherence to physical therapy, and a gradual return to activities. It's essential to keep in mind that while the path to recovery can be challenging, the end result often leads to improved mobility and a significant reduction in pain.

Alternatives to Knee Replacement Surgery

Before deciding on knee replacement surgery, one might want to consider several alternative treatments for knee pain. These options can range from lifestyle changes such as weight management and exercise to medical and therapeutic alternatives.

Weight Management and Exercise

One of the most effective non-surgical alternatives to knee replacement surgery is weight management and exercise. Losing weight can help lessen stress on the knees, reducing pain and making exercise easier. Carrying extra weight raises the risk of developing knee arthritis and speeds up the destruction of cartilage.

Exercises that strengthen the quadriceps and hamstring muscles can also help reduce knee pain and improve mobility. Low-impact exercises like biking or treadmill walking are often recommended. Physical therapy tailored to individual needs can be beneficial [8].

Medical and Therapeutic Alternatives

Several medical and therapeutic alternatives can help manage knee pain and possibly delay or avoid knee replacement surgery.

  • Stem Cell Therapy: This is emerging as a top knee replacement alternative. Stem cells naturally found in adult bone marrow and fat can repair damaged tissues in the knee joint, particularly helpful for those with knee osteoarthritis.
  • Gel Knee Injections: Also known as viscosupplementation, these injections contain hyaluronic acid to aid in joint lubrication, reduce inflammation, and promote bone and cartilage growth in the knee.
  • Medical Ozone Treatments: These treatments utilize ozone to reduce inflammation in the knee and promote better circulation for faster healing [9].
  • Cartilage Regeneration Techniques: Techniques like autologous chondrocyte implantation (ACI) involve growing cartilage cells in a lab and then surgically replanting them in the knee. This technique is beneficial for individuals with cartilage loss who are not severe arthritis patients [9].
  • Injections: Both cortisone shots and hyaluronic acid (HA) injections can provide temporary relief for knee pain.
  • Radiofrequency Ablation (RFA): When other treatments fail to control knee pain from osteoarthritis, RFA can be used to destroy sensory nerves responsible for carrying pain signals from the knee to the brain.

It's important to note that each alternative has its own benefits and drawbacks. Therefore, discussing these options with a healthcare provider is crucial to understanding the best approach based on individual needs and circumstances.

Living with a Knee Replacement

After undergoing knee replacement surgery, patients often find themselves navigating a new way of life. Adapting to the changes post-surgery and ensuring the longevity of the knee replacement are key aspects of this journey.

Lifestyle Adjustments Post-Surgery

Post-surgery, patients are advised to adhere strictly to a list of restrictions provided by their knee replacement specialist. These restrictions, including avoiding activities like kneeling, squatting, and driving that stress the knee joint, are gradually relaxed as the patient's health status improves within the first five weeks.

Patients with recent knee replacements may need walking aids for almost a month and a half post-surgery and require constant support for necessary movements. Initially, they may need assistance for daily chores and can transition from using a walker to crutches as their health improves [7].

It’s recommended to have a family member or friend available to assist 24 hours a day for the first week post-surgery, and to organize additional support from friends, family, or neighbors to check on them and help with tasks if needed.

Ensuring Longevity of Knee Replacement

To ensure the longevity of the knee replacement, a few key steps can be taken. Physical therapy is crucial post-surgery and begins as soon as the patient gets out of bed. The therapy focuses on maintaining range of motion, rebuilding muscle strength, and gradually transitioning to therapy at a clinic or virtually [6].

Most patients can walk without a walker or cane approximately six weeks after knee replacement surgery. The actual recovery period varies based on individual factors such as overall health and fitness level before the operation.

Patients can return to a fully active lifestyle after knee replacement surgery, progressively resuming activities like walking, biking, golf, skiing, and tennis. The wound healing process is aided by less invasive procedures, resulting in smaller incisions that are aesthetically pleasing and heal better.

In conclusion, living with a knee replacement involves making some lifestyle adjustments but can lead to a significant improvement in quality of life. By following the advice of healthcare professionals and taking proactive steps to ensure the longevity of the knee replacement, patients can look forward to a future with less knee pain.

References

[1]: https://www.healthpartners.com/blog/knee-replacement-risks/

‍[2]: https://www.healthpartners.com/blog/preparing-for-knee-replacement/

‍[3]: https://www.ucsfhealth.org/education/preparing-for-knee-replacement-surgery

‍[4]: https://www.healthline.com/health/total-knee-replacement-surgery/risks-complications

‍[5]: https://www.nhs.uk/conditions/knee-replacement/complications/

‍[6]: https://www.hss.edu/article_knee-replacement-recovery.asp

‍[7]: https://www.drpatelchirag.com/blog/3-common-issues-patients-face-after-knee-replacement/

‍[8]: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/knee-replacement-alternatives-to-consider

‍[9]: https://ethoshealthgroup.com/what-are-proven-knee-replacement-alternatives/