Your knees work hard during your daily routine, and arthritis of the knee or a knee injury can make it hard for you to perform normal tasks of daily life. If your injury or arthritis is severe, you may begin experience pain when you’re sitting down or trying to sleep. Sometimes a Total Knee Replacement is the only option for reducing pain and restoring a normal activity level. A total knee replacement involves cutting away the damaged bone of the knee joint and replacing it with prosthesis. This “new joint” prevents the bones from rubbing together and provides a smooth knee joint.
The goal of knee replacement surgery is to resurface the parts of the knee joint that have been damaged and to relieve knee pain that cannot be controlled by other treatments.
Over time, however, a knee replacement may fail for a variety of reasons. When this occurs, your knee can become painful and swollen. It may also feel stiff or unstable, making it difficult to perform your everyday activities.
If your knee replacement fails, your doctor may recommend that you have a second surgery—revision total knee replacement. In this procedure, your doctor removes some or all of the parts of the original prosthesis and replaces them with new ones.
Although both procedures have the same goal—to relieve pain and improve function—revision surgery is different than primary total knee replacement. It is a longer, more complex procedure that requires extensive planning, and specialized implants and tools to achieve a good result.
- Anti-inflammatory medications
- Glucosamine and chondroitin sulfate
- Pain medications
- Limiting painful activities
- Assistive devices for walking (such as a cane)
- Physical therapy
- Cortisone injections into the knee joint
- Viscosupplementation injections (to add lubrication into the joint to make joint movement less painful)
- Weight loss (for obese persons)
There may be other reasons for your doctor to recommend a knee replacement surgery
- Tibia. This is the shin bone or larger bone of the lower leg.
- Femur. This is the thighbone or upper leg bone
- Patella. This is the kneecap.
- Cartilage. A type of tissue that covers the surface of a bone at a joint. Cartilage helps reduce the friction of movement within a joint.
- Synovial membrane. A tissue that lines the joint and seals it into a joint capsule. The synovial membrane secretes synovial fluid (a clear, sticky fluid) around the joint to lubricate it.
- Ligament. A type of tough, elastic connective tissue that surrounds the joint to give support and limits the joint's movement.
- Tendon. A type of tough connective tissue that connects muscles to bones and helps to control movement of the joint.
- Meniscus. A curved part of cartilage in the knees and other joints that acts as a shock absorber, increases contact area, and deepens the knee joint.
- Your doctor will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.
- You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.
- In addition to a complete medical history, your doctor may perform a complete physical examination to ensure you are in good health before undergoing the procedure. You may undergo blood tests or other diagnostic tests.
- Notify your doctor if you are sensitive to or are allergic to any medications, latex, tape, and anesthetic agents (local and general).
- Notify your doctor of all medications (prescribed and over-the-counter) and herbal supplements that you are taking.
- Notify your doctor if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure.
- If you are pregnant or suspect that you are pregnant, you should notify your doctor.
- You will be asked to fast for eight hours before the procedure, generally after midnight.
- You may meet with a physical therapist prior to your surgery to discuss rehabilitation
- Arrange for someone to help around the house for a week or two after you are discharged from the hospital.
- Based on your medical condition, your doctor may request other specific preparation.
Once you are home, it is important to keep the surgical area clean and dry. Your doctor will give you specific bathing instructions. The stitches or surgical staples will be removed during a follow-up office visit.
To help reduce swelling, you may be asked to elevate your leg or apply ice to the knee.
Take a pain reliever for soreness as recommended by your doctor. Aspirin or certain other pain medications may increase the chance of bleeding. Be sure to take only recommended medications.
- Redness, swelling, bleeding, or other drainage from the incision site
- Increased pain around the incision site
You may resume your normal diet unless your doctor advises you differently.You should not drive until your doctor tells you to. Other activity restrictions may apply. Full recovery from the surgery may take several months.
It is important that you avoid falls after your knee replacement surgery, because a fall can result in damage to the new joint. Your therapist may recommend an assistive device (cane or walker) to help you walk until your strength and balance improve.
- Proper handrails along all stairs
- Safety handrails in the shower or bath
- Shower bench or chair
- Raised toilet seat
- Long-handled sponge and shower hose
- Dressing stick
- Sock aid
- Long-handled shoe horn
- Reaching stick to grab objects
- Removing loose carpets and electrical cords that may cause you to trip
- Avoiding stair-climbing until recommended by your doctor