Gregory L. Johnson, MD
Board Certified Orthopedic Surgeon
What is a total knee replacement?
Total knee replacement is a surgical procedure in which injured or damaged parts of the knee joint are replaced with artificial parts. Primarily, this type of surgery is performed on patients suffering from severe arthritic conditions which result from the wearing away of the cartilage in the knee joint. Circumstances vary somewhat, but generally you would be considered for a total knee replacement if you were experiencing any of the following symptoms: severe constant pain which restricts even ordinary everyday activities; significant stiffness of your knee, instability of your knee, meaning it "gives out" frequently; or a significant deformity such as lock-knee or bowlegs.
What is the procedure?
Total knee replacement is a major operation, and as such requires that certain preparatory measures be followed in the days leading up to, and including, the day of surgery. Your doctor would go over specifics with you regarding topics such as anesthesia options, blood clot prevention, and pain control. Satisfactory physical health should be maintained, and it is often a good idea to find activities which will help increase upper body strength so that it's easier to maneuver on crutches or a walker after the operation.
Most joint replacement surgery is done using general anesthesia. During the procedure, the ends of the thigh bone and shin bone, and usually the underside of the kneecap, are removed. Next, the ends of these bones are capped with artificial surfaces lined with metal and plastic. Knee joint components are then secured with cement.
How long is the recovery and what does it entail?
Following surgery, you would remain in the hospital for several days, during which time you would begin physical therapy. PT is a crucial step in the process, since it serves not only to achieve mobility in the new knee joint, but also to strengthen the muscles that support it. The goal of these initial therapy sessions would be to allow you to bend your knee 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. Upon your return home from the hospital, a continued exercise routine would be imperative so that strength and mobility can be regained.
Gradually, you would be able to resume normal physical activities such as golf, bike riding, swimming, dancing, and cross country skiing. High-impact activities, however, such as running, playing tennis, or movements that put a lot of stress on the joint, would most likely be discouraged by your doctor. The good news is that the pain you experienced prior to surgery would be greatly reduced or eliminated, and with the proper mix of continued exercise and care, a replacement knee can last anywhere from ten years to the rest of your life.
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