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.
Who Can Benefit From Knee Replacement
Each person is different, but your orthopedic care team will likely talk with you about a total knee replacement if:
- X-rays show advanced arthritis or significant deformity of your knee
- You have severe stiffness and swelling of your knee
- You have knee pain every day, even at rest
- You have significant instability, and your knee gives out/gives way
- You have made significant lifestyle changes and activity limits related to your knee
- You have a failed previous knee replacement
How Long Is It Before I Can Walk After A Knee Replacement
Most patients progress to a straight cane, walker or crutches within two or three days after surgery. As the days progress, the distance and frequency of walking will increase.
Patients are usually able to drive a car within three to six weeks after surgery and resume most other normal activities by or before six weeks. Complete recuperation and return to full strength and mobility may take four months or more. However, in many cases, patients are significantly more mobile one month after surgery than they were before they had their knee replacement
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Normal Anatomy Of The Knee
The knee joint is made up of three bones: the femur , the tibia , and the patella . There is a fourth bone, the fibula which lies along the side of the tibia, but it has only a small role in the function of the knee joint. These three bones work together to allow for flexing and extending the leg at the knee joint. The lower part of the femur connects to the upper part of the tibia and to the patella with ligaments, tendons, and other connective tissues. Amongst these connective tissues is a 2-part structure called the meniscus. The two parts are the inner side and the outer side. The meniscus helps to reduce friction, balance out the weight distribution in the knee, and acts as a shock absorber. The surfaces of the bones where they meet in the knee joint are covered in a special type of cartilage called articular cartilage. This cartilage is very strong and smooth, and it acts to reduce the friction in the knee joint even more. The patella is vital for knee function. Without the patella the knee joint would have a much more difficult time bending and straightening. You can think of the patella like a fulcrum and the leg bones like levers. You use a lot less energy to lift something using a lever with a fulcrum under it than just trying to move it with a lever alone. Since our knees have to support virtually all of our body weight, and have a lot of stress upon them during daily activities, things can sometimes go wrong.
Not All Hospitals Achieve The Same Results
Knee replacement is a surgery focused on reducing pain and getting you back to the activities you love. But not all hospitals achieve the same results. Some are more reliable than others. With the help of the HSS Hospital Reliability Scorecard, you can make sure you’re asking the critical questions to find the hospital that’s right for you. Understanding the data points will help you make the best decision for your care.
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How Long Is The Recovery
All patients heal from surgery at their own pace. Your doctor will tell you when it is safe to go back to your normal activities. Here are some guidelines:
- Household chores: 3-6 weeks
- Work: 4 weeks or more- depending on your job requirements
- Swimming: 6-8 weeks
- Driving: Before you can drive, will need to be off pain medicine and be abele to get in and out of the car. You may be able to start driving within 2 to 6 weeks–even if your driving leg was operated on.
Implanting The Tibial Component
The bottom portion of the implant, called the tibial tray, is fitted to the tibia and secured into place using bone cement. Once the tray is in place, the surgeon will snap in a polyethylene insert to sit between the tibial tray and the femoral component, and act as a kind of buffer. This insert will provide support for your body as you bend and flex your knee.
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When Surgery Is Recommended
There are several reasons why your doctor may recommend knee replacement surgery. People who benefit from total knee replacement often have:
- Severe knee pain or stiffness that limits everyday activities, including walking, climbing stairs, and getting in and out of chairs. It may be hard to walk more than a few blocks without significant pain and it may be necessary to use a cane or walker
- Moderate or severe knee pain while resting, either day or night
- Chronic knee inflammation and swelling that does not improve with rest or medications
- Knee deformity a bowing in or out of the knee
- Failure to substantially improve with other treatments such as anti-inflammatory medications, cortisone injections, lubricating injections, physical therapy, or other surgeries
Total knee replacement may be recommended for patients with bowed knee deformity, like that shown in this clinical photo.
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.
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How Do I Determine If I Need A Knee Replacement
If youre considering knee replacement surgery, talk to an orthopedic surgeon. Orthopedic surgeons specialize in operations to fix joints and muscles.
Your orthopedic surgeon will:
- Ask about your symptoms, including how severe they are and how long youve had them. The surgeon may also ask whether anything makes symptoms better or worse, or whether symptoms interfere with your daily life.
- Take your medical history to learn about your overall health.
- Examine you to check knee motion, strength and stability.
- Order X-rays of your knee. The images can help the surgeon understand how much damage is in your knee. Advanced imaging is rarely helpful in the arthritic knee.
The orthopedic surgeon will then make a recommendation for surgery or another treatment option.
Knee Replacement Surgeries For Bone
Your orthopedist may recommend a total or partial knee replacement for bone-on-bone knee pain relief, also called arthroplasty, if they diagnose your condition as being more advanced arthritis. Arthro means joint, and plasty means to make or create. When talking about joint replacement, arthroplasty and joint replacement are synonymous terms.
A total knee replacement is the most common knee replacement surgeries for bone-on-bone arthritis. This surgery involves resurfacing the ends of your knee joint bones, including the femur and tibia bone. This process is similar to capping a tooth.
Typically, metal components are cemented to the ends of the bone. A plastic or polyethylene insert or dish is placed between the two pieces of metal. After bone-on-bone knee replacement surgery, your joint is now metal gliding on plastic instead of grinding bone-on-bone. The result is no pain because there are no nerves in metal or plastic.
Surgery for bone-on-bone knee pain relief can take anywhere from 45 minutes to an hour and a half, depending on the unique presentations of a case.
A partial knee replacement resurfaces only one of the three knee compartments where arthritis is present. Your orthopedic surgeon will leave the healthy compartments of the knee intact. This differs from total knee replacement, where all three compartments of the knee are addressed at once.
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What Are Knee Replacement Implants Made Of
The selection of knee replacement prosthesis design and materials depends on each individual patient. The main implant components are made of metal â usually titanium or chrome-cobalt alloys. The implants are fixated in place either with a cement bonding agent or by osseointegration, in which a porous metal stem extends into the tibia and the patient’s natural bone grows into it. A plastic platform or spacer will be inserted between the tibial and femoral implant surfaces. The spacer is made of polyethylene.
Most femoral components are made of metal alloys or metal-ceramic alloys . The patellar component is plastic . The tibial insert component is also plastic . The tibial tray component can be made of the following materials:
- cobalt chromium
Using The Right Materials
Metals
With how a knee replacement is done at IBJI, our surgeons will often pick to use cobalt-chromium, an alloy, as a material for femur implants. Additionally, they sometimes use tibias made out of titanium.
In rare cases when a patient has a metal allergy, IBJI surgeons may use a ceramic-like material instead.
Plastics
During knee joint replacement, your surgeon may also use plastics unlike any used for common household goods, like childrens toys.
This is an ultra-high molecular weight polyethylene, Dr. Tauchen says. The plastic molecules are cross-linked at the molecular level, making a hard, durable material with favorable wear properties.
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Conditions That Can Be Treated With Knee Replacement
Knee replacement can be used to replace a knee joint affected by a range of conditions including:
- Severe osteoarthritis
- Ligament damage or infection that leads to severe osteoarthritis
- Rheumatoid arthritis
- Crystal deposition diseases such as gout and pseudogout
- Avascular necrosis death of bone following loss of blood supply
- Bone dysplasias disorders of the growth of bone.
Risks Of The Procedure
As with any surgical procedure, complications can occur. Some possiblecomplications may include, but are not limited to, the following:
-
Blood clots in the legs or lungs
-
Loosening or wearing out of the prosthesis
-
Continued pain or stiffness
The replacement knee joint may become loose, be dislodged, or may not workthe way it was intended. The joint may have to be replaced again in thefuture.
Nerves or blood vessels in the area of surgery may be injured, resulting inweakness or numbness. The joint pain may not be relieved by surgery.
There may be other risks depending on your specific medical condition. Besure to discuss any concerns with your doctor prior to the procedure.
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What Are The Types Of Knee Osteotomy
The two main types of osteotomy are opening wedge and closing wedge.
During a closing wedge osteotomy knee surgery, the surgeon cuts a wedge of bone from the leg and brings the sides of the opening together to close the space.
In some cases, the surgeon opens up a section of bone, rather than closing the bone. This procedure is called an opening wedge osteotomy. Sometimes a graft is used to hold the space between the ends of the osteotomy gap.
Knee Replacement Surgery Technologies
There are various ways surgeons can approach knee replacement surgery. Modern technologies are constantly advancing to improve patient outcomes.
To understand how a knee replacement is done, consider some of the following types of surgeries.
- Manual knee replacement uses specialized alignment guides
- Computer navigation-guided knee replacement surgery uses many digital points registered on the bone to give external feedback from a computer to help with sizing and alignment
- Patient-specific implants, or PSIs, in knee replacements require a CT or MRI ahead of the surgery, and there are custom cutting guides ordered ahead of time to exactly match the patients knee anatomy
- Robotic-assisted knee replacement surgery involves a saw attached to a robotic arm to guide the operation
With robotic-assisted knee surgery, Dr. Tauchen explains, at the time of surgery, you register the knee, and you use a probe and tell the computer where the knee is located in space in the room. Once you adjust the cut thickness and angles, it does not allow you to deviate from this plan when making your cuts. Its more accurate with more precise cuts.
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Helping Patients To Make Informed Decisions
We’re funding research to improve patient experience before, during and after knee replacement surgery. This includes a project based at the University of Sheffield which aims to help patients make informed decisions about their surgery. The research team will use the UK National Joint Registry dataset to develop and validate a personalised, web-based decision aid to help patients considering knee joint replacement to make informed choices about their treatment.
Extending The Life Of Your Knee Implant
Currently, more than 90% of modern total knee replacements are still functioning well 15 years after the surgery. Following your orthopaedic surgeon’s instructions after surgery and taking care to protect your knee replacement and your general health are important ways you can contribute to the final success of your surgery.
To assist doctors in the surgical management of osteoarthritis of the knee, the American Academy of Orthopaedic Surgeons has conducted research to provide some useful guidelines. These are recommendations only and may not apply to every case. For more information: Surgical Management of Osteoarthritis of the Knee – Clinical Practice Guideline | American Academy of Orthopaedic Surgeons
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How Long Will The New Knee Joint Last
For 8090% of people who have total knee replacement, the new joint should last about 20 years, and it may well last longer.
If you’ve had a partial knee replacement, you’re more likely to need a repeat operation about 1 person in 10 needs further surgery after 10 years.
The chances of needing another operation is greater if you’re overweight and/or involved in heavy manual work.
Learn More About Ibjis Knee Replacement Surgeons
More than 90% of modern total knee replacements are still functioning well 15 years after the surgery, according to research from the American Academy of Orthopedic Surgeons.
If your knee pain affects your quality of life, look to IBJIs highly trained surgeons and doctors. IBJI offers convenient locations across the Chicagoland area, and we are experts in arthritis treatment, pain management, and total knee joint replacement surgery.
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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.
How To Prepare For Knee Replacement
There are certain steps that can improve your recovery time and results. It is important to follow your knee replacement surgeonâs instructions both before and after surgery, as well as that of your rehabilitation therapistâs recommendations. Learn more about reparing for knee replacement by reading .
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How Long Does A Knee Replacement Last
Knee replacement implants are expected to function for at least 15 to 20 years in 85% to 90% of patients. However, the implants do not last forever.
After a period of 15 to 20 years, general wear and tear may loosen the implant. Depending on the patient, this may cause no symptoms, or it may cause any of the following:
- knee instability
When these symptoms arise, orthopedic surgeons recommend having to replace the original implant. Infection, especially, requires a prompt revision surgery. Infection after knee replacement surgery is rare, but a knee replacement implant cannot defend itself from infection if bacteria are introduced to the body. Learn more about the at HSS.
Who Should Consider Total Knee Replacement Surgery
It is usually reasonable to try a number of non-operative interventions before considering knee replacement surgery of any type. Prior to surgery an orthopedic surgeon may offer medications knee injections or exercises. A surgeon may talk to patients about activity modification weight loss or use of a cane.
The decision to undergo the total knee replacement is a “quality of life” choice. Patients typically have the procedure when they find themselves avoiding activities that they used to enjoy because of knee pain. When basic activities of daily life–like walking shopping or reasonable recreational pastimes–are inhibited or prevented by the knee pain it may be reasonable to consider the surgery.
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Why Is A Knee Osteotomy Done
All joints, including the knees, have cushioning tissue called cartilage where bones meet. Some people develop osteoarthritis when cartilage wears away in a joint, which can cause the tibia and femur to rub uncomfortably. This pressure can cause pain and stiffness in your knee.
Doctors perform knee osteotomy to shift pressure from the damaged part of the knee to an area with healthy cartilage and cushioning. This shift can reduce pain and improve mobility in the knee. A doctor may also use a knee osteotomy to repair a broken knee that did not heal properly.