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 patient’s questions and concerns, as well as those of the family, are answered.
The surgeon’s office should provide a reasonable estimate of:
- the surgeon’s fee
- the degree to which these should be covered by the patient’s 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?
Walk As Soon As Possible
Recovery from joint replacement surgery isnt always easy, but getting back on your feet as soon as the doctor says its okay can help you recover. Walking helps prevent complications like blood clots, improves circulation, and keeps your joints limber. You dont have to wait until you return home after surgery. Most patients can start walking while still in the hospital. Walking helps deliver important nutrients to your knee to help you heal and recover. You can expect to use a walker for the first couple of weeks. Most patients can walk on their own roughly four to eight weeks after knee replacement.
Different Types Of Surgery
There are 5 main types of knee replacement surgery:
- Total knee replacement. This is the most common form. Your surgeon replaces the surfaces of the thigh bone and shin bone that connects to the knee.
- Partial knee replacement. If arthritis affects only one side of your knee, this surgery may be a possibility. However, itâs only right for you if you have strong knee ligaments and the rest of the cartilage in the knee is normal. Partial knee replacement can be performed through a smaller cut than is needed for total knee replacement.
- Patellofemoral replacement. This replaces only the under-surface of the kneecap and the groove the kneecap sits in. This can be very effective for people with chronic kneecap arthritis.
- Complex knee replacement. This procedure may be needed if you have very severe arthritis or if youâve already had two or three knee replacement surgeries.
- Cartilage restoration: Sometimes when the knee only has an isolated area of injury or wear this area can be replaced with a living cartilage graft or cells which grow into cartilage.
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What Could Slow Down My Recovery
As with any surgery, there is some risk of complications during and after a hip replacement, which may include infection at the incision site, bone fractures and hip dislocations, explains Thakkar. If you notice a fever, drainage from the incision site, difficulty moving your hip or severe pain that is not relieved by your medication, contact your doctor immediately.
Taking rehabilitation at a comfortable pace and avoiding sudden, sharp movements can help prevent dislocations and falls that may delay the recovery.
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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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Setting The Stage For A Successful Outcome: Surgery At Hss
Partial knee replacement is widely recognized as a technically demanding surgery. As demonstrated in the scientific literature, data shows that choosing an orthopedic surgeon and institution with extensive experience with this procedure can help ensure a good result. In fact, at high-volume institutions like HSS, in well-selected patients, surgeons achieve the same longevity for partial knee replacement as that reported for .
Its important to understand that partial knee replacement is a challenging procedure to perform, says , Attending Orthopedic Surgeon at HSS. At HSS, we collect data on partial knee replacement patients on an ongoing basis. This allows us to continuously refine screening and surgical techniques to achieve predictable results and the best outcome possible.
Can Rehabilitation Be Done At Home
All patients are given a set of home exercises to do between supervised physical therapy sessions and the home exercises make up an important part of the recovery process. However, supervised therapy–which is best done in an outpatient physical therapy studio–is extremely helpful and those patients who are able to attend outpatient therapy are encouraged to do so.
For patients who are unable to attend outpatient physical therapy, home physical therapy is arranged.
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What Is Partial Knee Replacement Surgery
Partial knee replacement is where the bone surfaces of only compartment of the knee joint are removed and replaced with implants or resurfaced, while the bone surfaces of other compartments as well as unaffected cartilage and other soft tissues are preserved.
Patients with unicompartmental knee arthritis have cartilage degeneration in only one section or compartment of the knee. In cases where nonsurgical techniques do not provide symptom relief, surgeons can remove damaged cartilage and bone in the diseased area only, while preserving the ligaments that help support the knee joint, explains , Attending Orthopedic Surgeon at HSS.
A prosthesiswhich may also be called an implanttakes the place of the damaged area of the knee, leaving the other compartments intact.
Over the past 15 years, improvements in surgical techniques and instrumentation have made partial knee replacement a viable option for a growing number of patients in fact, recent data suggests that anywhere from 10 to 15% of all patients with osteoarthritis of the knee may be eligible for the procedure.
Do Follow Your Doctors Instructions On Caring For The Wound
To avoid post-op infection, be sure you understand how and when to change your bandage. If the skin aroundthe wound becomes red or drains, or if you develop a fever and chills, call your doctor right away. To avoidcomplications of a clot, call your doctor if your leg is tender, swells unduly below or above the knee, orif you develop pain in your leg or calf.
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Types Of Double Knee Replacement Surgery
Double knee replacement surgery may involve one surgery or two surgeries.
When both knees are replaced at the same time, the surgery is known as a simultaneous bilateral knee replacement.
When each knee is replaced at a different time, its called a staged bilateral knee replacement.
Either surgery may involve any combination of total knee replacement or partial knee replacement.
Walking Around After A Knee Replacement
To help make your recovery go as smoothly as possible, we need to start getting you active and mobile as soon as youre able. We understand you may be nervous about getting up for the first time, but well be there to help you whenever youre ready. Getting mobile is all about confidence, which is why we help you to progress through a range of walking aids until youre independent.
- Day of surgery: A physiotherapist will give you some exercises to do while youre in bed to help your new knee joint move and strengthen the muscles around it. Then theyll help you to get out of bed and start taking your first steps with a frame this is to prevent stiffness and maintain a healthy circulation.
- Day after surgery: Youll have an X-ray to check the position of your new knee, as well as some routine blood tests. If you havent started walking around yet, the physiotherapist will help you with this otherwise youll continue practicing to walk using a frame with your nurse until you can do so on your own.
- Second and third day after surgery: An occupational therapist will give you some tips for washing, dressing and getting on and off the bed, chair and toilet. The physiotherapist will help you transfer to crutches or a walking stick, before giving you some more exercises to increase your movement.
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Help With Medical Appointments
Keeping a calendar can help you track the persons daily needs, and can also help you stay on top of their appointments.
Missing an appointment may lead to setbacks or other complications, so its important to take note of their follow-up visits and plan accordingly. This includes transportation.
The person youre caring for will likely be unable to drive for the first 4 to 6 weeks following surgery. This means they will need someone to drive them to their appointments.
If any issues arise between appointments, dont hesitate to reach out to the healthcare team.
This may include questions about:
- medications or unusual reactions to them
- elevated temperature
What Is Recovery From Partial Knee Replacement Like
Following surgery, most patients undergoing partial knee replacement can expect to spend one to two nights in the hospital. At HSS, most patients are able to walk with assistance, or independently, on the same day as their surgery. Typically, the patient is given a cane within a week of surgery to allow for increased independence and begins outpatient rehabilitation. Patients are often finished taking prescription pain medication within four weeks post-surgery.
Partial knee replacement usually involves minimal blood loss and is associated with a low rate of complications most patients can expect to be back to their daily activities within three to six weeks. Many patients find that after undergoing physical rehabilitation, they are able to return to sports such as golf, within six to ten weeks.
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All You Need To Know Before Considering Replacement Surgeries For Both Knees Simultaneously
You may require a total knee joint replacement due to various medical reasons. An unfortunate accident which severely damages your knee or having debilitating arthritis are the most common reasons where people have to get their knee or both knees replaced.
Arthritis is a condition of inflamed joints and affects 15% of the Indian population. A damaged, worn off cartilage in one or both knees is a characteristic symptom of this disease. Total knee arthroplasty is an effective treatment option for arthritis and replaces your damaged joint and relieves pain.
Your doctor will substitute your knee joint with a prosthesis which is an artificial knee made up of either metal, plastic, or ceramic.
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What Activities Can I Do
In the early stages of total knee replacement recovery you should stick to activities that dont put too much force through the knee. Activities such as walking, swimming and gently cycling are all fine.
Start off slowly and gradually increase how much you do being guided by your knee. Gentle exercise is an important part of total knee replacement recovery as using the leg and strengthening the muscles helps the recovery process.
Higher impact activities such as running and sports should be avoided for the first 2-3 months. Dont be tempted to rush your total knee replacement recovery.
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Total Knee Replacement Recovery Time
The following timeline represents the recovery trajectory that is generally expected after total knee replacement surgery without complications or the presence of other conditions2-4.
Phase 1 : Hospital stay
After your surgery is complete you should expect to spend some time in the hospital where you will be closely monitored by physicians and assessed by a physical therapist or orthopedic surgeon. Once you achieve the hospitals discharge criteria you will be allowed to return home to continue your recovery in a more comfortable environment.
Phase 2 : Begin rehabilitation program & assisted movement
For the first several weeks you will be unable to walk without assistance devices like canes or walkers. You will likely experience difficulty performing simple activities of daily living such as sitting, walking, or climbing stairs and driving. Your knee will be stiff and sore, however, you will be given a supervised rehabilitation program to improve joint function and prescribed medication to manage the pain.
Phase 3 : Build strength, range of motion & retrain gait
Phase 4 : Build functional capacity and independence from assistance devices
Phase 5 : Return to recreational activities and demanding occupational duties
For individuals wishing to return to recreational activities or those that have significant physical occupational demands, further progression in rehabilitation may be required to achieve satisfactory outcomes.
Phase 6 : Majority of improvements have occurred
What Can I Do To Help My Recovery After Knee Replacement
Soon after surgery, you will be able to walk with a cane or a walker. But you will need help with everyday activities, such as:
Plan ahead to have a friend or loved one help you after surgery, or tell your healthcare provider if youll need help.
Your recovery will also be easier and safer if you adjust your home ahead of time. Things to consider include:
- Bench or chair in the shower, as well as secure safety bars.
- No tripping hazards, like cords and loose carpets.
- Secure handrails along any stairs if you use stairs.
- Stable chair with a back, two arms and a firm seat cushion, along with a footstool to elevate your leg.
- AVOID reclining chairs as they DO NOT allow for proper elevation of your post surgical leg.
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What Does Knee Replacement Surgery Involve
The team at Tri-State Orthopaedics provide the latest advancements in treating chronic knee problems. When conservative options arent enough, your provider may recommend knee replacement surgery. Also called arthroplasty, this procedure involves replacing the structure of the damaged knee joint with metal and plastic parts to restore the normal function of the knee and relieve chronic pain.
Knee replacement is an incredibly common and successful procedure. Over 90% of people who have knee replacement experience significant improvement in pain and their ability to get around. For most people, knee replacement restores a good quality of life, giving back independence and allowing you to engage in activities you used to enjoy. However, recovery is often a long road. If youre scheduled for or considering knee surgery, here are some helpful dos and donts in your path to recovery.
Whats It Like To Recover From A Knee Replacement
As soon as you wake up from knee replacement surgery, your rehabilitation can begin. Patients are encouraged to begin walking with a walker, crutches, or a cane on the same day that their surgery occurred. Within three to six weeks after total knee arthroplasty, you will gradually resume many of your normal activities, but not all until you are released from a doctors care.
Your physical therapist will help you learn to safely use the new joint and will go over all of the aftercare necessary to recover successfully from the surgery. They will help you use a continuous passive motion machine, to gently move the joint to speed the healing process. Youll also learn to change your bandage, and practice how to get to and from the bathroom. Your physical therapist will also teach you the exercises necessary to help you regain the full range of motion in your new joint.
Typically, you will return home as long as you have a support system in place to help care for you during the rehabilitation process.
You will have some pain, bruising, and swelling after the surgery. Your doctor will likely prescribe some pain medications that are stepped down to over-the-counter anti-inflammatories and pain relievers over time. Your orthopaedic surgeon may have you wear a support hose or compression boots to reduce the risk of blood clots and cut down on leg swelling.
- Slow, careful stair climbing
- Achieving full knee extension and knee flexion
- Standing up and slowly walking
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Is Bka Surgery Right For Me
While those suffering from severe pain or a traumatic injury in their lower leg may opt for below knee amputation surgery, there are some who dont qualify or face challenges for one or more of the following reasons:
- Inadequate blood flow Good blood flow contributes significantly to the bodys natural healing processes. In order to heal, tissue and bone need proper nutrients and oxygen, which are delivered via the bloodstream. If you have a history of poor circulation, have a proper evaluation before any surgery.
- Spreading infection or cancer If you are contemplating below knee amputation because of infection or tumors, its important to know the extent of the issue. Infections or tumors found above the knee may require a more extensive amputation.
- Muscle loss or scar tissue Muscle loss or scar tissue can inhibit the bodys ability to heal. Below knee amputees must have sufficient skin and muscle for the wound to heal properly and to use a prosthetic.
- Inadequate knee function Limited knee function or significant knee pain may inhibit your ability to use a prosthetic following BKA surgery.