Preparation For Total Knee Replacement Surgery
Patients undergoing total knee replacement surgery usually will undergo a pre-operative surgical risk assessment. When necessary, further evaluation will be performed by an internal medicine physician who specializes in pre-operative evaluation and risk-factor modification. Some patients will also be evaluated by an anesthesiologist in advance of the surgery.
Routine blood tests are performed on all pre-operative patients. Chest X-rays and electrocardiograms are obtained in patients who meet certain age and health criteria as well.
Surgeons will often spend time with the patient in advance of the surgery, making certain that all the patients questions and concerns, as well as those of the family, are answered.
Costs
The surgeons office should provide a reasonable estimate of:
- the surgeons fee
- the degree to which these should be covered by the patients insurance.
Total Knee Replacement Surgical Team
The total knee requires an experienced orthopedic surgeon and the resources of a large medical center. Some patients have complex medical needs and around surgery often require immediate access to multiple medical and surgical specialties and in-house medical, physical therapy, and social support services.
Finding an experienced surgeon to perform your total knee replacement
Some questions to consider asking your knee surgeon:
- Are you board certified in orthopedic surgery?
- Have you done a fellowship in joint replacement surgery?
- How many knee replacements do you do each year?
Different Types Of Knee Replacement Surgeries
You may wonder whether robotic knee replacement surgery is better. You might come across information about different types of knee replacement surgeries and the latest developments in knee replacement surgery, minimally invasive knee replacement surgery, lateral knee replacement surgery, alternative knee replacement surgery techniques and robotic versus traditional knee replacement surgery.
Springer says it can be hard for people to sift through the conflicting information they find. People come in and say they want a certain type of prosthesis, or a specific technique or technology, he said.
Surgeons usually have reasons for choosing the devices and techniques they use. I tell patients to focus on researching your surgeon. Once youve found a surgeon you mesh with, have an open and honest discussion of techniques and technologies to find whats best for you, Springer said.
Knee replacement is major surgery, so its natural for people to look for easier alternatives. They sometimes ask about non-invasive knee replacement surgery. But its impossible to perform surgery non-invasively. They also ask about cartilage replacement knee surgery. That can work, according to the Arthritis Foundation, but its typically recommended for people who have injured their cartilage.
What Causes A Hyperextended Knee
Hyperextension of the knee usually occurs due to a direct blow to the knee or by anything that forces the knee joint to bend too far backward. Common causes of a hyperextended knee include
- Car accident: During a car accident when the knee may be forcefully impacted.
- Falling: Falling when the foot is caught.
- Landing hard: Landing incorrectly after a jump or unbalanced landing.
- Jumping on the back: When someone jumps on a persons back suddenly without warning, it can cause the person to be off-balance, resulting in a hyperextended knee.
- Skiing: If a skier crashes on a snowbank, their body will continue to move forward while the feet are fixed, leading to a hyperextended knee.
- Sports: A hyperextended knee may be caused during sports that involve
- Extreme contact at high speeds such as football, soccer, skiing, or lacrosse.
- Flexibility and landing such as gymnastics.
- Quick changes in direction and leaping such as basketball.
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How Long Does Knee Replacement Surgery Take
Wanting to learn more about how long knee replacement surgery takes to perform? Ill share my surgery time when I had TKR.
My actual knee replacement surgery took approximately 2 hours and 45 minutes to perform. This included falling asleep just before surgery and when I woke up.
However, the process for TKR Surgery actually begins the night before your surgery. After dinner you are no longer able to eat or drink liquids.
You also have been given a bathing kit with directions. Thenight before you go to bed, you are instructed to thoroughly wash your body withthe soap and washcloths that they provide.
The next morning you are instructed to bathe again exactlylike the night before. Then, you are off to the hospital.
If everything goes well, expect to be home the next day.Below Ill share a few more details of my experience.
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The success rate for knee replacement surgery is high. Overall, its a widely successful surgery, Dr. Bryan D. Springer, fellowship director of the OrthoCarolina Hip and Knee Center in Charlotte, North Carolina, and a spokesperson for the AAOS, told TODAY. If you look across all surgeries its one of the most frequently utilized thats based on success.
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Good Data On Joint Replacement Are Hard To Find
Its difficult to predict how long a joint replacement will last for several reasons. One is that it can take a decade or more to collect data on past operations to predict the success of future operations. Another challenge is that in recent years, theres been a tendency to operate on younger people, including baby boomers who are more active in their 50s and 60s and may expect more of their new joints than prior generations. Age is of particular importance, because a person with a life expectancy of 15 years has a much better chance of avoiding a future operation than a person with a life expectancy of 30 years. In addition, younger patients tend to be more active and put more stress on their new joint. For these reasons, some surgeons advise younger patients to put off surgery as long as possible, even if that means suffering with pain, stiffness, and reduced mobility.
What Can I Expect During Recovery And Rehabilitation
Most people are up and walking within 24 hours with the aid of a walker or crutches.
Following your operation, a physical therapist will help you bend and straighten your knee, get out of bed, and ultimately learn to walk with your new knee. This is often done on the same day of your operation.
Most people are discharged from the hospital 23 days after surgery.
After you return home, therapy will continue regularly for several weeks. Specific exercises will aim to improve the functionality of the knee.
If your condition necessitates it, or if you dont have the support you need at home, your doctor may recommend spending time at a rehabilitation or nursing facility first.
Most people recover within 3 months, although it may take 6 months or longer for some people to recover fully.
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When Should I Have A Double Knee Replacement Done
A total knee replacement may be performed if there are signs of advanced joint disease and treatment has failed to provide pain relief. The pain will affect the patients quality of life. A patients age is also determining the factor to a knee replacement should be performed. It is preferred for a patients age in order to perform a total knee replacement.
How Long Will I Be In Hospital
We practice the Enhanced Recovery Pathway , which is a modern, evidence-based approach that helps people recover more quickly after having major surgery. Our physiotherapists begin working closely with patients within hours of joint replacement surgery, getting them up on their feet and growing their confidence. The length of stay at our hospital can be significantly shorter as a result. Early mobilisation and a return home reduces the risk of deep vein thrombosis and infections, as well as making patients feel more comfortable. With this support you will be mobile enough to go home as early as the day after your operation. You will be given exercises and instructions on how to use mobility aids such as crutches and sticks.
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The Biggest Mistake With Pain Managment
The biggest mistake most people make is not utilizing the opioids to their fullest extent early when they are really needed, focusing on restoring range of motion first and foremost. If the range task lingers, so will the opioid use, they go together hand in glove.
If youve restored your range of motion and are slowly progressed your strength exercises you should not have a great deal of pain going forward.
The longer one takes an opioid prescription, the more difficult it will be to get off opioids after knee replacement surgery, which leads into this next section about the consequences of using a lot of opioid pain medication prior to surgery.
What To Expect After A Total Knee Replacement
If you struggle with chronic knee pain and knee mobility, your doctor may recommend total knee replacement surgery once conservative treatment options are exhausted. Knowing what to expect after a total knee replacement can help you regain knee strength and mobility so that you can resume independent living more quickly.
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Tips To Speed Up Recovery Post Knee Replacement
Is It Safe To Go Home The Same Day After Knee Replacement Surgery
Based on data from the Agency for Healthcare Research and Quality, more than 600,000 people in the United States have knee replacement surgery each year. Though routine and common, a hospital stay may be required following the procedure. But with advances in surgical procedures, its possible to go home the same day after your knee replacement surgery.
At Chicago Orthopaedics & Sports Medicine, our skilled orthopaedic surgeon, Vasili Karas, MD, MS, performs many advanced knee replacement procedures and, depending on specific factors, he may consider it safe for you to go home the same day you get your new knee.
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Contact Orthobethesda To Learn More
If you believe that you are a candidate for total knee replacement, we invite you to reach out to us online to schedule an appointment at OrthoBethesda.
- 1635 N. George Mason Drive #180 Arlington, VA
- Ph 567-4706
- 4420 North Fairfax Drive, Suite 100 Arlington, VA
- Ph 419-3002
- 10215 Fernwood Road, Bethesda, MD 20817
- Ph 804-1137
Where Will I Feel Knee Replacement Pain
As mentioned above, knee replacement pain can come in many different forms depending on the cause. Knee pain is to be expected due to the surgical procedure itself, with swelling, bruising, and the introduction of prosthetic parts.
Beyond that, it is possible to feel pain in parts of the body other than your knee. This is known as referred pain.
Your hips, lower back, groin area, and calves may initially hurt due to the change in your stance and the way you walk. Of course, it is also typical to feel sore due to extended amounts of time in bed during your recovery.
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What The Alternatives To Knee Replacement
A healthcare provider may recommend knee replacement surgery after other treatments for knee pain dont help anymore. These earlier options may include:
- Exercise or physical therapy to strengthen the muscles around the joint which will provide stability.
- Medications such as NSAIDs and cortisone shots.
- Walking aids or supports and bracing.
When Should I Seek Medical Attention After Knee Replacement
After you go home, call your healthcare provider right away if you develop any of the following symptoms:
- Chest pain and/or shortness of breath.
- Fever higher than 101 degrees Fahrenheit .
- Incision problems, like bleeding, leaking, swelling, redness or odor.
- Pain in your calf, ankle or foot that is new and gets worse.
A note from Cleveland Clinic
If you have severe knee pain but medications and therapy arent helping, knee replacement may provide the answer. This common and effective surgery can reduce pain and get you back to everyday activities. Talk to your healthcare provider or an orthopedic provider about whether knee arthroplasty is a good option for you.
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How Long Will My Knee Replacement Last
This varies depending on the patient, but knee replacement implants are very strong and durable. With todays advancements in technology, especially when it comes to polyethylene, knee implants are lasting more than 15-20 years for most patients.
If you and your orthopedic surgeon have decided that you are a good candidate for total knee replacement, start planning ahead so you can focus on your recovery for the best possible outcome. Remember that youre likely to come out of surgery as active as you go into surgery, so aim for regular low impact exercise and joint movement that you can complete without pain. Carefully following your surgeons instructions after a total knee replacement will ensure you protect your implant and prolong the success of your joint replacement.
Knee Replacement Pain: After Six Months
pain after total knee replacement surgery, Credits: pexels
If you are still experiencing pain six months after surgery, you may be wondering how long it will be until you feel normal again.
In some cases, it may take up to a year for all of your swelling to completely go away. Your knee will continue to recover for years to come, as scar tissue forms and your muscles become stronger with continued physical therapy and light exercise. You should seek the help of your doctor.
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How Long Will I Need Physical Therapy After Knee Replacement Surgery
Physical therapy is one of the key parts of your recovery. Physical therapists like myself use a combination of exercises, education and hands-on care to strengthen your body, teach you how to avoid injury and help you learn how to use your new knees.
Youll start regularly working with physical therapists within the first week after surgery. At TRIA, well work with you to develop a personalized therapy plan, which usually involves about three months of meeting with your physical therapist.
These first three months of physical therapy after knee replacement surgery are critical to setting you up for a successful recovery. And many of the moves you learn will be useful long-term to keep your joint feeling good.
Treatment plans are unique to each patient, but heres what you can expect:
One to three weeks after surgery
The first few weeks after knee replacement surgery your physical therapist will focus on helping you reduce pain and feel more confident on your feet.
Youll start working on a daily routine of strengthening and flexibility exercises with your physical therapist. During this time, youll also work on bending your knees, getting up from a sitting position and walking.
Typically, youll be able to bend your knees at a 90 degree angle, fully straighten your knee, and walk for at least 10 consecutive minutes during this stage of physical therapy.
Four to six weeks after surgery
Seven to 12 weeks after surgery
12 weeks after surgery and beyond
Knee Replacement Recovery Time Varies From 3 To 6 Months
We understand that while the surgery may be over, your journey is still unfolding. It can take up to three months before youll be able to return to your activities. In certain cases, it may be six months before your knee is strong and resilient enough to take on demanding sports. Strength improves for a year.
Well work with you throughout your knee replacement recovery to ensure you are progressing well.
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What Should I Expect In The First 6 Weeks
Recovery takes time. You may still need assistance from a partner, friend or relative for several weeks after you return home.
All patients will experience swelling which can take 3 4 months to settle. You may also notice numbness of the skin around the wound. Your knee will feel stiff, especially if you have been immobile, but this will settle with time.
It is normal to have a small amount of bleeding into the dressing for up to a week. If there is bleeding that completely soaks the dressing, this will need review please contact Dr Schluters rooms for advice.
Crutches are provided to help you balance when walking. The crutches may be needed for a month or so while you build up muscle strength, and the pain and swelling resolves. As your balance improves and you regain strength, you should use one crutch for support before walking for periods without assistance.
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Pain will gradually improve and movement will increase.
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You will gain more independence and will start to feel better about having had the replacement performed.
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You will need to see your GP at 12 days for staple removal. Please take the supplied staple remover with you.
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An exercise regime will help strengthen muscles and prevent the joint getting stiff
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For the first 4 weeks, gentle daily walking on even surfaces is a good form of exercise
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From 4 6 weeks onwards, daily use of an exercycle if possible is excellent for your recovery
The dressing on your wound is waterproof, and it is fine to shower with it.