How Many Knee Replacements Can You Have
Most people whom I have met only had one knee replacement surgery. Several other friends and acquaintances have had two, one on each knee.
The reality is that you can have several knee replacements in a lifetime and many people will have 2 if they had their first knee replacement at an early age.
One friend who I play pickleball with had 4 surgeries on the same knee in the last 5 years. I will share some of the reasons why this might occur.
He had his first TKR at age 58. He was very fit at the time and he looked forward to relieving the pain he felt in his knee and improving the overall function of his knee.
After his first TKR he experienced a heart attack in the hospital during his post-operative recovery . Needless-to-say he stayed in the hospital longer than he expected and his knee replacement rehab was postponed for several days.
He recovered well from TKR and the heart attack, then he worked hard on his rehab. Even though his knee became stronger, it never felt quite right after the surgery.
A few months after the surgery, his knee became infected and he had a second surgery to clean out the knee.
He rehabbed again but he still encountered problems with his knee. A year later a new physician advised him that the first doctor misaligned the implant and he would need to have a revision .
This problem led to a 4th surgery. It has been 7 months since his last surgery. At age 62 he has had a total of 4 operations .
Alternative Surgeries For Younger Patients
Determining when the right time for a joint replacement is can be hard enough for any patient, let alone younger adults who have to be realistic about how long an artificial joint can last. Here are some of the procedures that can delay your need for a total knee replacement. .
High Tibial Osteotomy or Distal Femoral Osteotomy
HTO and DFO are for younger patients who have unicompartmental articular cartilage damage. In the surgery, bone is either removed or added to the tibia or femur. The procedure shifts body weight from the damaged part of the joint and reduces pain. By realigning the knee, body weight is transferred to the healthy, outer or inner parts of the knee. This slows the progression of osteoarthritis, letting you keep your natural joint for longer.
Pros: With this procedure, younger patients can engage in high-impact activities like jogging or tennis which are discouraged after a total or partial replacement.
Unicompartmental Knee Arthroplasty
Pros: Like a total replacement, UKA delivers long-term results of 10-15 years or more. The incision is smaller and the recovery time tends to be shorter than the full-fledge TKR.
A final word of advice for the younger men and women dealing with chronic joint pain and osteoarthritis: think about the long-term when plotting your next move, do your research, and know that the discussed orthopedic procedures are among the most successful in modern medicine.
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How Long Do Revised Knee Replacements Last
What happens if your knee replacement reaches the end of its working life? Jim Newman explains.
A couple of years ago, I wrote an article about a paper produced by the University of Bristol which found that you could expect most knee replacements to last 25 years. As I said then, this was unquestionably good news, giving encouragement to anyone of any age who feels they may need a knee replacement operation.
As you might expect, though, there are a fair few caveats to that. If you lead an active lifestyle, do a job thats hard on the knees or are a little on the heavier side, 25 years may be something of a stretch. And even if your knee replacement does last a full 25 years, what happens once that time is up?
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What Happens During Knee Arthroplasty
The day of surgery, you will receive anesthesia to prevent pain during the operation. You will have either a regional or general anesthetic. Your anesthesia team will decide what type of anesthesia is right for you.
Knee arthroplasty takes about an hour or two. The surgical team will:
- Make an incision in the knee area.
- Remove any damaged cartilage and bone.
- Place the knee implant and position it properly.
- Secure the implant into place using cement or without cement.
- Insert a piece of polyethylene that creates a smooth, gliding surface between the metal parts of the implant.
- Close the incision.
How Common Is Knee Replacement Surgery
The surgery is very common. Surgeons started doing it in the 1960s, with regular updates to techniques and implants along the way.
Almost 800,000 knee replacements currently get performed each year in the United States. The surgery is often done in older adults whose knees have worn down over time. But its also become popular in middle age, as people want to stay active.
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You Can Expect A Well
With proper care and maintenance, your prosthetic knee should function well for 10 to 15 years. The implant will serve you for a long time if you refrain from high-impact activities that might dislocate or damage the implant. It greatly helps to maintain a healthy weight and to follow your doctors and physical therapists instructions.
When Can I Get Back To My Everyday Activities After Knee Arthroplasty
Your doctor will give you specific instructions. But many people can get back to their everyday activities three to six weeks after surgery.
Your healthcare provider will give you specific instructions about recovery. You will gradually increase activity, starting with a slow walking program. You will be encouraged to stand, climb stairs and perform other normal household activities as soon as possible.
The Dangers Of Knee Replacement Surgery
Millions of Americans suffer from osteoarthritis in their knees, leading to over 790,000 knee replacements being performed every year in the United States. However, knee replacements arent actually the permanent fix that they may seem to be. In fact, many patients actually report more pain after their knee replacement than they experienced before the procedure.
Knee replacements can be a good option for some people, but they arent the only option for relieving osteoarthritis pain. Along with the possibility of continued or worsened pain after a knee replacement, there are a number of other factors to consider when weighing treatment options for chronic osteoarthritis pain.
Can Knee Replacements Last 30 Years
The Food and Drug Administration recently approved a manufacturer to label an implant that passed laboratory tests as good for 30 years of use. The claim of resilience is significant, but the company is cautious in its statements.
In general, metal and plastic knee replacement devices are made of. It is common to notice that these materials begin to wear, as if they were rubber on your car tires. According to a study, most types of knee replacement can last for more than 20 years. Some patients may require a second knee replacement after only a few years of living. The metal and plastic used to make knee replacement implants are the same as those used to make dentures. A knee replacement may be possible for 30 years. A knee implants average lifespan ranges from 15 to 20 years. Artificial knee joints are being made more durable by using newer materials and designs.
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What Are The Risk Factors For A Failed Knee Replacement
Age, activity level, surgical history and a persons weight can contribute to implant failure. Younger, active patients, people who are obese, and those who have had prior knee surgeries all have a higher increased risk of a failed implant.
Younger, more active patients have a higher rate of revision than older, less active patients because they place more stress on their prosthesis over more time. Obese patients have a higher incidence of wear and loosening because of the increased force of their weight, and they are more prone to infections because of their increased risk of wound healing. Patients with previous knee surgeries are at higher risk for infection and implant failure.
What Should I Do If Im Considering Knee Replacement Surgery
Getting a knee replacement is a big decision. If you think its time to start the discussion, make an appointment with an orthopedic doctor.
A doctor will talk with you about your symptoms, medical history, and goals, examine your knees, review any X-rays or imaging tests youve had done, and work with you to determine if a knee replacement is your best care option.
At TRIA, our orthopedic surgeons are among the best in the Midwest. Were committed to providing accurate diagnoses and expert answers to help you decide whats best for you. Well never push you toward surgery. If we dont think its the right time for you to get a knee replacement, well talk to you about non-surgical knee treatment options that may help reduce or heal pain, and improve your knee function.
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Can You Get A Third Knee Replacement
There is no definitive answer to this question as it depends on individual circumstances. Some people may be able to get a third knee replacement if their first two surgeries were successful and they are still experiencing pain or mobility issues. However, others may not be candidates for another surgery due to factors such as age, health, and activity level. Ultimately, it is important to speak with a doctor to determine if a third knee replacement is right for you.
According to one study, approximately one-third of total knee replacement surgeries in the United States do not meet the standard of care. In the future, the authors hope to develop better criteria for selecting patients. Between 1991 and 2010, Medicare spent 162% more on knee replacement. A five-year study involving 175 patients found that total knee replacements were not associated with an increased risk of mortality. The doctor should think about whether or not a patient meets the criteria for a knee replacement. According to the doctor, a joint replacement patients pain score should be more than seven out of ten. Steven F. Harwin, MD, a well-known rheumatologist and co-director of the Cleveland Clinics Joint Diseases Program, stated that loss of quality of life is the primary indication of joint surgery.
What Is The Newest Knee Replacement
Minimally-invasive quadriceps-sparing total knee replacement is a new surgical technique that allows surgeons to insert the same time-tested reliable knee replacement implants through a shorter incision using surgical approach that avoids trauma to the quadriceps muscle which is the most important muscle
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Your Recovery At Home
You may need some help at home for several days to several weeks after discharge. Before your surgery, arrange for a friend, family member or caregiver to provide help at home. You may need a walker, cane, or crutches for the first few days or weeks until you are comfortable enough to walk without assistance.
Up To A Third Of Knee Replacements Pack Pain And Regret
Danette Lake thought surgery would relieve the pain in her knees.
The arthritis pain began as a dull ache in her early 40s, brought on largely by the pressure of unwanted weight. Lake managed to lose 200 pounds through dieting and exercise, but the pain in her knees persisted.
A sexual assault two years ago left Lake with physical and psychological trauma. She damaged her knees while fighting off her attacker, who had broken into her home. Although she managed to escape, her knees never recovered. At times, the sharp pain drove her to the emergency room. Lakes job, which involved loading luggage onto airplanes, often left her in misery.
When a doctor said that knee replacement would reduce her arthritis pain by 75 percent, Lake was overjoyed.
I thought the knee replacement was going to be a cure, said Lake, now 52 and living in rural Iowa. I got all excited, thinking, Finally, the pain is going to end and I will have some quality of life.
But one year after surgery on her right knee, Lake said shes still suffering.
Im in constant pain, 24/7, said Lake, who is too disabled to work. There are times when I cant even sleep.
Most knee replacements are considered successful, and the procedure is known for being safe and cost-effective. Rates of the surgery doubled from 1999 to 2008, with 3.5 million procedures a year expected by 2030.
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Will I Need Any Treatments After Knee Replacement
Your healthcare team will prescribe medications to help you manage pain after surgery, such as:
To prevent blood clots and control swelling, your healthcare team might also recommend:
- Blood thinners, such as aspirin or injectable Enoxaparin based on individual risk of blood clot formation.
- Compression devices, usually used while hospitalized. These are mechanical devises which provide intermittent compression.
- Special support hose.
Your team will ask you to move your foot and ankle around frequently to maintain blood flow at home. Theyll also show you special exercises to help strengthen your knee and restore motion. Exercises are very important to the success of your knee replacement. Initially, physical therapy will be in the home. Arrangements for this in home PT are made at the time of discharge from the hospital.
Understanding Why Some Joint Replacements Fail
We’re also supporting research to improve the outcome of knee replacement surgeries, such as a project aimed at increasing the understanding of why joint replacements sometimes fail by investigating whether there are genetic risk factors that influence surgery outcome. This research has the potential to improve patient experience and increase the life of the joint replacement.
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What Is Physical Therapy
Physical therapy is a health care service that helps you restore body movement and your physical functionality through non-invasive methods.
For example, a physical therapist may help someone learn to walk again following a stroke or injury. For those who have had a knee replacement, a physical therapist is an important part of the healthcare team. By working closely with your physical therapist, you can regain the range of motion in your leg, helping you return to the activities you once enjoyed.
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How Painful Is A Total Knee Replacement
The overall pain, overnight stay in the hospital, pain medication, coming off of the anesthesia, swelling and bruising isnt for the faint of heart. The second day out of my surgery I was expecting visitors, but the effects of the anesthesia wearing off was too much for me to bare and I had to cancel their visit.
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The Best Time For Knee Replacement Surgery
It is widely regarded as a cost-effective and time-saving procedure. However, patients who are deemed to be candidates for knee replacement surgery should not wait too long after the procedure. As a result, if you wait too long after the procedure, you are more likely to require a revision total knee replacement.
How Long Will My Hip Or Knee Replacement Last
- By Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing
For people considering hip or knee replacement surgery, its something they want and need to know.
In the US alone, surgeons perform more than 600,000 knee replacements and about 330,000 hip replacements each year. These operations can provide a major improvement in quality of life and function for those with severe arthritis. On the other hand, there are risks associated with the operation , there is a long road to recovery even when all goes well, and these operations arent cheap. For knee replacement surgery alone, an estimated $9 billion or more is spent each year in the US .
So, if the first joint replacement is unsuccessful for some reason , a second operation may be necessary. And thats a big deal, especially since “revision surgery” is technically more difficult, recovery can take longer, and success rates may be lower than first operations.
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Nerve And Other Tissue Damage
There’s a small risk that the ligaments, arteries or nerves will be damaged during surgery.
- Fewer than 1 in 100 patients have nerve damage and this usually improves gradually in time.
- About 1 in 100 have some ligament damage this is either repaired during the operation or protected by a brace while it heals.
- About 1 in 1,000 suffer damage to arteries that usually needs further surgery to repair.
- In about 1 in 5,000 cases blood flow in the muscles around the new joint is reduced . This usually also needs surgery to correct the problem.
Revision Knee Replacement Vs Knee Replacement
Many of the patients who have had revision knee surgeries achieved favorable outcomes: significant pain relief and increased stability and mobility. Nonetheless, absolute pain relief and restoration are not always achievable, and there are patients who still experience knee pain and stiffness long after their revision surgery.
Its also worth noting that compared to the initial knee replacement, a revision knee replacement doesnt guarantee the same longevity. While initial knee replacements can last up to twenty years, revision knee surgeries only typically last about ten.
A revision knee replacement also has a higher risk of complications, such as bleeding and blood clots, infection, and reaction to anesthesia, compared to that with the original replacement surgeryall the more so if the patient already has extensive scarring from the initial procedure.
Moreover, given its greater complexity, a revision knee replacement involves more extensive preoperative planning and takes longer to perform. The surgeon has to remove the original implant, which would have already fused into the existing bone . Removing the prosthesis can result in significant bone loss. In such a case, the surgeon will require a bone graft to fill the void, support the new prosthesis, and encourage new bone growth. Bone grafting is a procedure in which a piece of bone is transplanted from another area of the body or from a donor.
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