How Big Will My Scar Be
The size of the incision can vary and depends on several factors that include the size of the patient, the complexity of the surgery, and surgeon preference. Most studies have shown that smaller incisions offer no improvement in pain or recovery and may actually worsen the surgeons ability to adequately perform the procedure.
What Is Knee Replacement Surgery
Knee replacement surgery is a surgery to replace parts of your knee joint with new, artificial parts. You may need a knee replacement if you have knee damage that causes severe pain and difficulty doing daily activities, such as walking and climbing stairs. It is usually done when other treatments for knee pain haven’t helped enough. The goal of a knee replacement is to relieve pain and help you move better.
People of all ages may have knee replacement surgery. But it is more common in older people. The decision whether to have surgery is based on your overall health and how much your knee bothers you.
Your Recovery Timeline: What To Expect After Knee Replacement Surgery
After knee replacement surgery, most patients wonder how long it will take before theyre back to feeling normal. For example, how long does it take to get a full range of motion? You may also be wondering how long you can expect any lingering stiffness to last. While every case is unique, there are typical timeframes you can use as a guideline.
Your range of motion capabilities often progress rapidly during the first three months following surgery, provided you are working with a physical therapist and following your doctors recommendations. Your range of motion may continue to improve for up to two years after your surgery.
You can expect to use a variety of stretches and exercises in order to achieve optimal motion with your replaced knee. The normal range of motion after a knee replacement is defined as being able to bend your knee back to 90 degrees.
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Theres No Hip Or Knee Replacement Guarantee
Unfortunately, no one can be sure that a hip or knee replacement will be the last operation needed on that joint. No operation is 100% successful, and nothing lasts forever. In addition, a number of factors, including surgical technique and surgeon experience, how many operations a particular hospital or surgeon performs each year, and patient factors can all have powerful effects on how long a replaced joint lasts.
But we do have an idea of how long a joint replacement will last based on data from past surgeries. During my training in the 1980s and 1990s, the teaching was that up to 90% or more of hip or knee replacements would last at least 10 to 15 years. We still quote similar numbers. But it might be better than that. With better preparation prior to surgery , improved materials in the replacement, better surgical techniques and anesthesia, and better physical rehabilitation after surgery, your joint replacement of the knee or hip is more likely to be successful and last the rest of your life than ever before. At least we hope thats the case.
New Hip And Knee Replacement Data
A recent study examined how long knee or hip replacements last, and how their durability is affected by the persons age at the time of surgery. As published in the April 2017 edition of the medical journal The Lancet, researchers found that:
- Among more than 60,000 people who had a hip replacement, only 4.4% required revision surgery in the first 10 years after surgery, but by the 20-year mark, 15% required revision.
- Among nearly 55,000 people who had a knee replacement, only 3.9% required revision surgery within 10 years of surgery by 20 years, 10.3% required revision.
- Age did matter. Of those over 70 having hip or knee replacement, the lifetime risk of having a second operation on the replaced joint was about 5%. But this risk was much greater in younger individuals, especially for men. Up to 35% of men in their early 50s required a second operation.
Some orthopedic surgeons might scoff at these findings and say, “My patients do better than those in in this study.” And that may be true. But increasingly, hospitals and surgeons are being required to make public their results, so if youre considering hip or knee replacement and your surgeons results are truly better, or worse, than average, hopefully youll be able to find out.
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Genicular Nerve Block With Radiofrequency Ablation
Instead of more invasive surgical options, many patients turn to a genicular nerve block to treat and diagnose persistent knee pain. A genicular nerve block uses anesthetic injected into one or more of the genicular nerves to interrupt pain signals being sent to the brain.
Unfortunately, a genicular nerve blocks effects only last eight to 24 hours. Doctors use genicular nerve blocks to test the effectiveness of the procedure on a persons knee pain. Many patients who experience relief with genicular nerve blocks will then get radiofrequency ablation. When combined, these two procedures can offer pain relief that lasts anywhere from six months to a year.
Providing Better After Care For Patients
We’re funding research which aims to provide a standardised approach and assessment for virtual clinic follow-up of total joint replacement patients and subsequent management of patients identified as ‘at risk’ by this approach. This study would enable us to deliver better and more streamlined after care for patients.
The Durability Of Knee Replacements
When it comes to how long knee replacements last, the answer isnt always the same. It depends on the patients condition and on the implant itself. However, a detailed analysis has shown that over 95% of replacements lasted for at least 10 years and 85% of replacements made it past the 15th year.
However, there was also a study that showed even better results, with over 85% of replacements still functioning at the 20 years mark.
So, depending on the quality of the implants and surgery, the knee replacements can last at least 10 to 20 years.
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.
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Addressing Inflammation In The Body You Can Help
Inflammation is a natural response within the body, and lets us know when things are out of balance. Its a natural part of the healing process, following knee replacement surgery, for the area around the replacement to be inflammed.
There are steps that can be taken to ensure the bodys inflammation response is healthy and normal, and these include eating a diet lower in inflammation-causing foods, and allowing a specialist in the field of using movement and tension release exercises to reduce secondary inflammation that might come from compensatory body mechanics.
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What is the recovery timeline for a total knee replacement?
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Living With A Knee Replacement
Total knee replacement may greatly improve function, but most patients will not be able to do more than they did before the onset of arthritis.
A replacement knee may feel different than a natural knee. One small study3 found that most people report being aware of their new knees even 12 months after surgery. Their awareness was most notable when climbing stairs, kneeling, or rising from a chair. About half of the people in the study also reported symptoms such as knee stiffness , swelling, crackling, or numbness.
These symptoms can exist even though overall knee function is improved and knee pain is decreased. These symptoms do not mean the knee replacement surgery was not successful or that patients regretted having the surgery.
When To Seek Treatment For Your Arthritis
Arthritis doesnt have to spell the end of an active life. If you are experiencing worrisome symptoms or persistent pain, the renowned arthritis specialists at Summit Orthopedics can help. We work with you to confirm a diagnosis and develop an appropriate conservative treatment plan. If nonsurgical treatments fail to support your lifestyle goals, fellowship-trained orthopedic surgeons will consult with you and discuss appropriate surgical options. Summit is home to innovative joint replacement options. Our Vadnais Heights Surgery Center is one of only two surgery centers nationally to receive The Joint Commissions Advanced Certification for Total Hip and Total Knee Replacement.
Summit has convenient locations across the Minneapolis-St. Paul metro area, serving Minnesota and western Wisconsin. We have state-of-the-art centers for comprehensive orthopedic care in Eagan, MN, Plymouth, MN, Vadnais Heights, MN, and Woodbury, MN, as well as additional community clinics throughout the metro and southern Minnesota.
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Knee Implants Are Like Cars Mileage May Vary
Knee surgeon Dr. Kristoffer Breien explains that implant longevity varies from person to person. I ask my patients, If you buy a new car for your mom, and a new car for your son, which car will last longer? How good those cars are going to look in five years is all a matter of how you treat them. A knee implant is very similar. When you get it, its brand new. It just rolled off the lot. How it will perform in 10 or 20 years is a question of how you treat it and what you do with it. A knee implant in a 40-year-old runner is probably going to wear out faster than the same implant in a 65-year-old who enjoys strolling in the evening.
Alternatives To Knee Replacement Surgery
Most experts suggest exhausting your conservative alternatives before committing to a full knee replacement surgery. This is especially true for those that dont fit the criteriafor optimal candidacy. Knee surgery is a permanent alteration to your body, therefore once the decision is made, if the results werent what you were expecting there really isnt any going back. Approximately 20% of knee replacement patients say they are unsatisfied with the final result3. For a comprehensive overview of all the treatments available for knee osteoarthritis, check out our osteoarthritis treatment guide.
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What Did This Study Do
This study was made up of a systematic review and meta-analysis of published case series, and a meta-analysis of data from national joint registries. The authors found 33 case series, with a total of 7,232 knee replacements. Twenty-six case series looked at total replacement, while seven reported survival of unicompartmental replacement. Data from the Australian and Finnish national registries were used, with a total of 299,291 total replacements, and 7,714 unicompartmental.
The quality of the published case series was low. And only the Finnish registry had outcomes data at 20 and 25 years.
Side Effects And Complications From Knee Replacement Surgery
Knee surgery is an invasive procedure that comes with risk both during and after. Approximately 2% of patients will have surgical complications, this number is higher for those with co-morbidities . The most common complications that occur during knee replacement surgery are:
- Blood Clots: A lack of circulation to the lower area of leg below the knee can increase the risk of blood clots. This can be life-threatening should a blood clot break free and travel up the venous system into your lungs2.
- Infection: like any surgery infection is always a risk. This can occur superficially around the healing surgery wound or internally within the tissues surrounding the new prosthesis. The latter is more serious, and could result in another surgery2.
There are also issues that can occur with the implant itself during the recovery period or due to irregular use thereafter. Check out the full overview of the possible issues with knee prostheses here.
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What Happens During Surgery
Prior to surgery, your physician and surgeon will consider things like weight, the condition of existing bone and cartilage, and other medical factors, and will have a plan in place post-surgery for optimal healing.
During knee replacement surgery, your doctor will make an incision, moving your knee cap, and cutting away any damaged bone, cartilage, and joint surfaces. This is then followed by the attachment of artificial joints, which are tested by rotating and bending the new knee replacement, before the incision is closed up with stitches and/or surgical staples.
Factors during the surgery, including blood loss, and unforeseen medical issues involving the condition of the bone, cartilage and underlying muscle can have an impact on recovery time and post-op pain following a knee replacement surgery.
Pain after knee replacement surgery is sometimes caused by biological factors present before the surgery, while others may be caused by complications and conditions during the surgery itself.
Arthritis is an example of a biological factor that may be present before the surgery, which can flare up after knee replacement surgery. Similarly, patients with pre-existing concerns about fibromyalgia may find their pain response heightened after knee replacement surgery for as much as six months.
Is ‘revision Rate’ Really The Best Measure Of Success
Revision rate is just one of a number of different factors that can be used to assess potential success after knee replacement surgery. Importantly, however, it would be completely wrong to say that a knee replacement prosthesis is a great success, just because its lasted many years, if the patient themself has actually been left with a painful or stiff knee, with poor function, and if theyve had to endure years of unhappiness and disappointment! Just because a knee prosthesis hasnt been revised, it doesnt mean that the patient themselves, are actually happy and that they personally would consider the surgery as a success.
Patient satisfaction, function, knee kinematics and prosthetic survivorship are all factors that influence and contribute to overall success after knee replacement surgery, and one has to consider each of them individually, but also all of them collectively, when considering actual outcomes after knee replacement surgery.
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Anatomy Of The Knee And Associated Ailments
The knee is comprised of three bones, the Tibia , the Femur , and the Patella . These bones align in such a way that allows them to bend. The muscles, tendons, and ligaments surrounding the knee serve as stabilizing agents. There is fleshy cartilage between the bones which acts as a cushion, preventing the bones from rubbing against one another called bursa.
When someone experiences pain in the knee, there are several potential causes. The three most common are:
- Osteoarthritis: soft tissues in the body degrade naturally over time. When the cushions between bones begin to deteriorate and the bones begin to rub against each other, this is called arthritis. This condition can cause a great deal of pain and occurs predominantly in people over the age of 50, but can occur to anyone at any time.
- Injury: an injury can occur for many reasons, including a sports injury, falling, or a traumatic injury such as a car accident. When these occur, the bones not only experience trauma but may realign in such a way that causes pain. These can include torn cartilage, a torn ACL, or broken bones.
- Overuse: repetitive motion in the knee can lead to more rapid degeneration of the soft tissue.
Certain individuals may be more prone to knee pain than others due to their lifestyle. These people include:
Why Does My Knee Replacement Hurt After A Year
The most common causes of pain after knee replacement include: Loosening of the implant: This is most often the cause of pain years or decades after the knee replacement however, it is seldom the cause of persistent pain right after surgery. 3 Infection: Infection is a serious and worrisome concern.
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What Did It Find
Data from the national registries provided the most reliable results:
- For total knee replacements, 93.0% were still intact at 15 years . At 20 years, 90.1% of replacements had survived . 82.3% of replacements were still intact at 25 years .
- For unicompartmental replacements, 76.5% were still intact at 15 years . At 20 years, 71.6% had survived . 69.8% were still intact at 25 years .