Your knee is the largest joint in your body. It functions as a hinge joint, allowing you to extend your leg back and forth with little effort, and supports a great deal of body weight along the way.
Because of the amount of stress knees bear, they are also more likely to be susceptible to arthritis and severe injury, according to Arthritis Health.
Total knee replacement surgeries are usually performed on those experiencing debilitating pain due to advanced arthritis or injury.
Total knee replacement surgery (or total knee arthroplasty) is a procedure where surgeons resurface damaged portions of the knee due to injury or advanced-stage arthritis.
As one of the most successful procedures in all of medicine, total knee replacement surgery is also fairly common. The Journal of Rheumatology estimates that over 790,000 total knee replacements are performed each year in the U.S., and this number is estimated to surpass 1.3 million by 2030.
Here’s what you need to know if you’re considering knee replacement as a treatment option.
An overview of total knee replacement surgery
It is important to note that total knee replacement surgery is considered advanced-stage treatment. It is typically sought out by and offered to patients whose knee pain or discomfort has completely disrupted their quality of life.
In a total knee replacement procedure, surgeons remove degenerated surfaces of the knee joint and replace them with a knee prosthesis or artificial joint.
The end goal of total knee replacement surgery is to relieve knee pain that cannot be managed by non-invasive treatments.
Dr. Vladimir Alexander, orthopedic surgeon and founder of Alexander Orthopaedic Associates, says that treatment options are offered on a case-by-case basis.
“As experts in knee replacement and revision knee replacement surgery, our practice is uniquely qualified for exactly all cases and complicated issues.”
How total knee replacement surgery works
Total knee replacement is typically performed while patients are under general anesthesia. However, this could vary, depending on risks and any pre-existing health conditions.
After you change into the doctor-provided gown, you’ll likely receive an IV. Next, you will be positioned on the operating table, and, based on your doctor’s recommendation, be administered general anesthesia.
Prior to the surgeon operating, your incision site will be marked and cleaned with an antiseptic solution. Your surgeon will then make an incision, open your knee and remove the degenerated surfaces of your knee joint. Next, the surgeon will resurface the knee with a prosthesis made of metal and plastic. These prostheses are typically created to replace the damaged surface of the tibia (shin bone).
Throughout the surgery, the anesthesiologist will closely monitor your heart and breathing rates, as well as your blood oxygen level.
What are the benefits of knee replacement surgery?
Deciding whether or not to have a knee replacement can be a major decision, but it is important to understand what the procedure can realistically do for you.
Knee replacement can:
- Relieve pain and discomfort
- Restore function
- Improve quality of life
Knee replacement cannot:
- Completely reverse the damage caused by arthritis
- Allow the same range of motion as your natural knee
- Enable you to engage in high-impact activities like running or jumping
Who needs total knee replacement surgery?
Typically, knee replacement surgeries are performed on patients aged 60 to 80. However, young adults and even children are eligible candidates if they have a condition that demands total knee replacement surgery for pain relief and an improved quality of life.
Typically, your doctor will recommend a total knee replacement when:
- Pain persists despite taking pain medication
- Pain is consistently severe, day or night
- Pain interferes with everyday tasks, like standing up, dressing, bathing, climbing stairs or sleeping
- You need to use a cane, walker or crutches to get around
- Your knee bows in or out – a sign of arthritis or severe injury
- You’re in a high-risk group for arthritis – between 60 and 80 years of age
What conditions does total knee replacement surgery treat?
Total knee replacement surgery treats a number of conditions, including:
- Osteoarthritis: Known as “wear and tear” arthritis, osteoarthritis is the most common form of arthritis. It impacts your entire knee joint, while also breaking protective cartilage down. This can result in bone-on-bone rubbing, which often results in swelling, pain, and causes additional damage to the knee.
- Rheumatoid arthritis: An autoimmune disorder that causes inflammation to form in the joints as a result of the body attacking its own tissue or even organs.
- Post-traumatic arthritis: Causes the same symptoms as osteoarthritis, but develops following a fracture or tear due to injury or trauma.
- Kneecap fracture: An injury caused by directly falling on or receiving a blow to your patella (i.e., your kneecap colliding with a car dashboard in an auto accident or playing sports). Sustaining knee fractures puts patients at further risk of developing osteoarthritis.
- Anterior Cruciate Ligament (ACL) Tear: Typically caused by fitness-
related injuries the planting of the foot (from changing direction, sudden slowing down/stopping or landing from a jump) causes the knee to lock and twist simultaneously, tearing the ligament. Only severe cases of ACL tears need a total knee replacement.
What happens if you don't get total knee replacement surgery?
While there are many treatment methods available to reduce pain and increase range of motion, final-stage, total knee replacement should not be delayed.
However, the vast majority of patients with osteoarthritis – 90%, according to research by the Journal of Bone and Joint Surgery – wait too long to get a replacement. This causes osteoarthritis to further deteriorate the surface of their knee and reduce function. In this case, knee replacement would not be effective for getting function back.
While the choice to undergo knee replacement surgery is completely up to the patient, Dr. Alexander recommends weighing your options as soon as possible.
“Prolonging surgery will cause unnecessary pain that could be alleviated with surgery,” Dr. Alexander said. “Following surgery, patients can return to their normal lifestyle.”
How long does it take to recover from total knee replacement surgery?
On average, patients usually take between three and four months to recover from total knee replacement surgery. However, the rate of healing and regaining function depends on how well you follow your doctor’s instructions.
Due to the severe pain caused by injury to or arthritis in the knee, some patients may even feel better immediately after surgery – despite incisional discomfort.
What is post-operative pain like?
Depending on the severity of our patient’s preoperative conditions, healing time can range.
“Pain is very manageable within 2-3 days,” Dr. Alexander said. “This pain medication starts before the nerve block wears off to stay ahead of the discomfort.”
Despite the strides you make in your recovery process, it’s still important to rest, follow your recovery plan and check-in with your physician if you have any complications after surgery.
What are the risks of total knee replacement?
While all surgeries run the risk of complications, some risks associated with total knee replacement surgery are:
- Blood vessel/nerve injury during surgery
- Bleeding at site of incision
- Blood clots in the legs/lungs, which could lead to pulmonary embolism
- Deep vein thrombosis
- Dislocation or loosening/wearing out of the prosthesis over time
- Prolonged pain or stiffness
- Risk of stroke, heart attack or pneumonia, associated with general anesthesia
How long do knee replacements last?
Most knee replacements will last upwards of 15 years. At Alexander Orthopaedic Associates, our experts have developed proprietary surgical
techniques that ensure faster healing and longer lasting knee prosthetics.
Our knee replacements are specifically designed to last upwards of 30 years, chances of complications and re-injury aside.
Is total knee replacement considered major surgery?
A knee replacement is considered major surgery. As the procedure has become more advanced since its conception in the late 1960s, it has also reduced the need for a prolonged hospital stay.
As a result, our total knee replacement surgeries are performed as an outpatient procedure, meaning that you can heal in a more comfortable, familiar place than a hospital. Because a lot of healing is mentality-based, we’re confident that these outpatient procedures help our patients heal sooner.
Alexander Orthopaedic Associates’ Outpatient Advantage
From diagnosis to recovery, we are committed to your health and well-being – throughout the total knee replacement surgery process and beyond.
With surgical advancements, an outpatient total knee replacement surgery can help improve your quality of life and help you avoid a long hospital stay.
Our outpatient orthopedic surgery centers and expert surgeons provide the care you need before, during, and after surgery.