Based upon your history, x-rays and physical exam, your orthopedic surgeon can make some general recommendations. However, you will know when the time is right for you. We will ask you to decide if your discomfort, stiffness, and inability to perform tasks justify undergoing surgery. There is no harm in waiting to have surgery if conservative, non-operative methods can adequately control your discomfort. When your knee pain is stopping you from doing the things you love, may be the right time.
Why does my knee hurt? The bones in your joints are covered by a layer of cartilage. Cartilage is a tough lubricating tissue that provides smooth, pain-free motion to your joints. Arthritis causes the cartilage to wear away, eventually resulting in painful bone-on-bone contact. Pain, inflammation, and stiffness is the result of the bones rubbing against each other.
What is a total knee replacement? This involves surgical removal of the arthritic joint surfaces. Basically the knee joint and the damaged cartilage is replaced with a metal and plastic prosthesis by cementing these components into the bone.
How long does the knee implant last? All implants have a limited life expectancy depending on the patient’s age, weight, activity level and medical conditions. On the average most total knee replacements last between 15 and 20 years.
What are the risks of surgery? Infection (<1%), blood clots, damage to nerves or arteries, stiffness, implant failure, death. To help avoid these complications surgeons routinely prescribe antibiotics and blood thinners during and after surgery.
How do I prepare for the best surgery outcome? Some orthopedic surgeons recommend 4-6 weeks of physical therapy before your surgery to get your muscles around the knee joint and hip in the best possible condition to enhance your recovery after surgery.
How long does it take to recover? Initially it takes approximately 6 weeks for the soft tissue (muscles, ligaments, tendons) to heal. You will begin walking with support (walker or crutches) the day after surgery. Most patients are able to negotiate stairs by 3 days and are discharged to home. You will continue to use support for 3-6 weeks and do your home exercise program. You may ride in a car but will not be able to drive a car for 4-6 weeks. Return to work depends on the type of work you do. Office workers may return as early as 3 weeks.
Here is a timeline guide:
Can I kneel on my new knee? After 3 months you may start kneeling. Approximately 50% of patients are able to kneel and 50% cannot kneel due to discomfort.
Do I need physical therapy after my surgery? For the first 6 weeks you will do your home strengthening program that the in-patient physical therapist gave to you at the hospital. At your 6 week and 3 month check up with your surgeon you can evaluate together if physical therapy may help you get back to doing the things you want to do. Physical therapy can help promote a good range of motion and help to decrease any swelling and stiffness in the joint. It is hard to stay motivated and know how much to move through any discomfort, the support of a physical therapist guiding your through your recovery could be the key to a successful outcome. Physical therapy can address any muscle imbalances as a result of compensating from years of knee pain.
