• Knee Replacement
• Hip Replacement
• Meet the Physicians

• Overview
• Knee Pain Assessment Quiz
• Total Knee Replacement
• Knee Replacement FAQs
• Partial Knee Replacement
• Unicompartmental Knee Replacement

About the Knee

• Knee Anatomy
• The Knee Replacement Procedure
• Minimally Invasive Knee Replacement
• Physical Therapy and Exercises

Total Knee Replacement

Total knee replacement can be an extremely successful surgical procedure. The first knee replacement procedure was performed more than 30 years ago. Since then, millions of people have received knee replacements. Knee replacement surgery is a fairly routine procedure with more than 400,000 being performed every year in the United States alone.* Total knee replacement, also called arthroplasty, involves removing the diseased bone and cartilage and resurfacing it with orthopedic implants.

The word replacement makes one think that surgeons remove the entire knee. In truth, your surgeon only resurfaces damaged bone and cartilage at the ends of the bones in your joint. During surgery, the joint is exposed by an incision, made down the center or off to the side of the knee. The damaged bone ends are then resurfaced with components designed to recreate the natural contours of the bones in a healthy knee. The metal and polyethylene (plastic) implants allow the bones to smoothly glide against each other, much like natural cartilage.

Total knee replacement is performed while you are under anesthesia. There are various types of anesthesia available and your physician will explain your options to you before surgery. The length of surgery may be approximately 1-1/2 - 2 hours. Care before surgery and time spent in the recovery room can add an additional two to three hours before you are back in your hospital room.


Complications
While uncommon, complications can occur during and after surgery. Some complications include, but are not limited to, infection, blood clots, implant breakage, malalignment, and premature wear, any of which can require additional surgery. Although implant surgery is extremely successful in most cases, some patients will experience stiffness and pain. No implant will last forever and factors such as the patient’s post-surgery activities and weight can affect longevity. Be sure to discuss these and other risks with your surgeon.

There are many things that your surgeon may do to minimize the potential for complications. Your surgeon may have you see a medical physician before surgery to obtain tests. You may also need to have your dental work up to date and may also be shown how to prepare your home to avoid falls.


After Surgery
After surgery, you will receive pain medication and begin physical therapy. It is important to start moving your new knee as soon as possible after surgery to promote blood flow, to regain knee motion, and to facilitate the recovery process. You may also be out of bed and walking with crutches or a walker within 24 hours of your surgery.

You will be shown how to safely climb and descend stairs, how to get into and out of a seated position, and how to care for your knee once you return home. It is a good idea to enlist the help of friends or family to help you once you do return home.

Before you leave the hospital, your therapist will show you a variety of exercises designed to help you regain mobility and strength in your knee. You should be able to perform these exercises at home.

Most people are ready to go home between three to five days after surgery; however, some people may go to a separate rehabilitation facility, which your surgeon should discuss with you before surgery. Many will go directly home and begin supervised therapy either at home or as an outpatient. When at home, it is important to continue with your exercises as your surgeon has instructed.


Recovery
Exercise is necessary for proper healing. Your surgeon may recommend therapy to assist with gentle leg movement, strengthening, and mobility exercises between 24 - 48 hours after surgery. Therapy will begin in the hospital and usually continues after discharge for approximately six weeks.

Diligent physical therapy, proper diet, and a willingness to follow all of your surgeon’s recommendations will contribute to a more successful recovery after surgery. Most patients are able to walk without support and drive three to six weeks after surgery. Activities such as golf, doubles tennis, and swimming can usually be resumed, but only after a thorough evaluation by your surgeon. Always follow your surgeon’s recommendations, as recovery time will vary for each patient.

Most patients are typically not allowed to participate in high-impact activities or contact sports. These types of activities place extreme amounts of pressure on the joints, which could lead to complications. Ask your surgeon which activities you should avoid after surgery.

Your surgeon should set a follow-up schedule for the first year after surgery to evaluate your progress. You will be seen every year or two thereafter. Complications can occur with implants, so it is important to see your surgeon if you notice any unusual changes regarding your new joint.


Summary
We realize that the decision to have surgery is sometimes difficult. Millions of others have made this choice, allowing them to return to more active lifestyles. This guide is not intended to replace the experience and counsel of your orthopedic surgeon. If you have further questions, please speak with your orthopedic surgeon.


References
*DeFrances CJ, Hall MJ, Podgornik, MN: "2003 National Hospital Discharge Survey: Advance data from vital and health statistics," No. 359, Hyattsville, MD: National Center for Health Statistics, 2005.

Patient Education information provided by Biomet, Inc. - Advanced Science for Real Living™