When To Have Knee Surgery

What Is Life Like After A Knee Replacement

After recovering from surgery, most people can move better with less pain than before surgery. But having an artificial knee is not the same as having a normal, healthy knee.

You need to protect your new knee by:

• Nerve damage
• Scarring that limits how far you can bend your knee

Your age, general health, and how active you are can all affect your risk of having a problem after knee replacement surgery.

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 therapywhich is best done in an outpatient physical therapy studiois 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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Whats Recovery Like After Total Knee Replacement Surgery

If the patient is in good health , they may be able to undergo minimally invasive knee replacement in an ambulatory surgical suite. In these cases, the patient normally goes home the same day of their surgery. Patients are encouraged to begin walking as soon as possible, usually directly after their surgery. Patients are typically at the surgical suite for about 5-6 hours for their procedure and are then able to recover at home. This is especially important in the COVID-19 era. It gives many patients a lot of relief to know they can safely have their joint replacement and then recover at home instead of being in a hospital where other diseases are being treated.

Home physical therapy will start the day after surgery. This typically lasts 2 weeks while the patient is in the initial phases of recovery. Outpatient physical therapy usually begins about 2 weeks after the surgical procedure. The physical therapist will work one-on-one with you to strengthen the knee and restore range of motion while reducing scar tissue.

Typically, a knee replacement surgery takes one to two hours and most patients can resume normal light activities within six weeks. Driving can occur in three to six weeks depending on which leg was operated on and how the recovery process is going. Full recovery and return to normal activities such as tennis, aerobics, and other high-intensity activities could take four to six months depending upon the situation and individual patient.

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How Will I Feel When I Get Home

Do not be surprised if you feel extremely tired at first. You have had a major operation and muscles and tissues surrounding your new knee will take time to heal. Follow the advice of the surgical team and call your GP if you have any particular worries or queries.

You may be eligible for home help and there may be aids that can help you. You may also want to arrange for someone to help you out for a week or so.

The exercises your physiotherapist gives you are an important part of your recovery. It is essential you continue with them once you are at home. Your rehabilitation will be monitored by a physiotherapist.

Your Condition Could Get Worse As Your Joint Deteriorates

The leading cause of knee replacement is osteoarthritis. If you wait too long to have surgery, you put yourself at risk of experiencing an increasing deformity of the knee joint. As your condition worsens, your body may have to compensate by placing additional strain on other parts of the body . This could lead to stress or pain in the back, knee, or other parts of the body.

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Local Retiree’s Knee Surgery In Lithuania ‘like Clockwork’

Max Johnson in his home in Winnipeg after returning from Lithuania, where he underwent knee surgery.

Posted: 7:00 PM Nov. 18, 2021

Max Johnson has returned from his latest overseas trip with a souvenir: a new knee.

The former Winnipeg travel agency owner is now home after undergoing knee replacement surgery at Nordorthopaedics Clinic in Lithuania shaving off the minimum 18 months he was expected to have to wait for such a procedure in Manitoba.

Max Johnson, who returned from Lithuania with a new left knee on the weekend, submitted an invoice for 9,953 euros, or $14,431.85, to Gordon on Thursday.

Johnson has argued that’s a deal because a government report shows the procedure cost $21,430 in Manitoba in 2019.

“It would be nice if they sent me a cheque, but I would like them to resolve the problem of waiting lists,” said Johnson, a former travel agency owner, on Friday.

“They will have to put more resources to do it. During these disruptive times, with waiting lists of thousands of people, we should be able to go outside the regular protocol.

“If we can get it done for less money , I believe people should be able to do it and the province should pay for it. This is a crisis and we have to do something to lower these numbers.

“We have no choice at this time.”

“This is a crisis and we have to do something to lower these numbers.” Max Johnson

She failed to directly answer the question and said Health Minister Audrey Gordon would deal with it.

Personal Stories About Having Surgery For An Acl Injury

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

My knee is only a little unstable after my ACL injury. My doctor said the decision to have surgery is really up to me. I am going to do some intensive rehab for a few weeks and see how my knee progresses. If I can avoid surgery, I’d like to do that.

Don, age 42

I’m not a competitive athlete, but I am very active and I enjoy running, hiking, and bicycling. My doctor said that my ACL tear wasn’t too bad, but I am definitely going to have surgery. I think surgery is my best chance of being able to continue to do all the things I did before I hurt my knee.

Susan, age 38

I’m not a very active person, and so it isn’t too important to me that my knee be stable. It only has a small amount of instability right now, so I am not going to have surgery. I feel like the risks of the surgery are more than the risks of not having it, at least for someone like me.

Carmen, age 53

I need a stable knee to do my job well, and I’d also like to avoid getting osteoarthritis early if I can. I’m going to have the reconstruction surgery, even though I know the rehab is long. It’s the best chance I have of getting a strong, stable knee.

Peter, age 45

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What Is Recovery Like

You can start moving the knee the day of your surgery. Your knee function should return rapidly and with less pain than with total knee replacement. Youll work with a physical therapist to mobilize the knee while in the hospital and for two to four weeks after discharge. Youre usually discharged no later than one or two days after surgery.

Youll need medication to guard against formation of a blood clot while in the hospital and maybe for a period of time after youre discharged.

If all goes well, you should be back to full activity in about six to eight weeks. Impact exercises or jogging/running may not be recommended because the replacement includes a bearing surface that can wear. However, activities like tennis, skiing, and other sports are okay. This, of course, is why partial knee replacement is even being considered to return you to activities you enjoy.

Last reviewed by a Cleveland Clinic medical professional on 12/16/2020.

References

You Have Bad Arthritis

Most people who undergo a knee replacement have either osteoarthritis, the wear-and-tear type of arthritis rheumatoid arthritis, an autoimmune condition that causes joint pain and damage or post-injury arthritis.

Osteoarthritis, rheumatoid arthritis and posttraumatic arthritis affect the knee through different mechanisms, however, these different conditions are similar in that they all result in loss of cartilage, which causes pain and loss of motion, says Nathanael Heckmann, MD, an orthopaedic surgeon at Keck Medicine of USC and an assistant professor of clinical orthopaedic surgery at the Keck School of Medicine of USC. When these symptoms become severe, knee replacement surgery may provide considerable symptom relief by replacing the worn-out surfaces of the knee.

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How Does Knee Pain Affect Lifestyle

How pain is perceived and tolerated is unique to each individual. If knee pain affects working, socializing, sleeping, maintaining good hygiene, or other daily activities, then it may be time to consider knee replacement surgery.

Knee pain and active lifestylesPeople who live active lives may be more affected by knee pain and decide to have knee replacement surgery sooner. For example, a person whose regular activities include standing for work, babysitting grandchildren, and walking a pet dog may be more affected by arthritic knee pain than a person who lives a more sedentary life.

See Knee Pain and Arthritis

Pain and joint damage do not always match upThe decision to have knee replacement surgery should not be based solely on medical imaging that shows severe knee degeneration. Rather, it should be based on moderate to severe knee arthritis symptoms that correlate with medical imaging.

See Knee Osteoarthritis Diagnosis

For example, a person whose x-ray shows a severely degenerated knee but who experiences only mild pain is probably not a good candidate for knee replacement. In contrast, a person who has a moderately degenerated knee and experiences severe pain may be a good candidate for knee replacement.

Your Care Team And Support Person

Our goal is to provide you with the care and support needed to get through your joint replacement and back to the things you love to do. A Total Joints Nurse Coordinator is available to ensure a smooth transition from surgery to recovery. We also encourage you to choose a family member or friend who can act as a personal support person or “coach” as you go through the joint replacement process.

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Your Knee Is Always Swollen

Swelling is another sign your knee is not responding to other treatments.

A knee that is consistently swollen despite the use of anti-inflammatory medications, steroid injections and physical therapy suggests degeneration of the cartilage and/or instability of the knee, which can be confirmed with an X-ray, Lieberman explains. This can make you a candidate for a total knee replacement, he says.

Risks Of Knee Replacement Surgery

Knee replacement surgery is a common operation and most people do not have complications. However, as with any operation, there are risks as well as benefits.

Complications are rare but can include:

• stiffness of the knee
• infection of the joint replacement, needing further surgery
• unexpected bleeding into the knee joint
• ligament, artery or nerve damage in the area around the knee joint
• persistent pain in the knee
• a break in the bone around the knee replacement during or after the operation

In some cases, the new knee joint may not be completely stable and further surgery may be needed to correct it.

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What Else Do You Need To Make Your Decision

Check the facts

• Sorry, that’s not right. Surgery with physical rehabilitation offers the best chance to have a stable knee and an active lifestyle.
• You are right. Surgery with physical rehabilitation offers the best chance to have a stable knee and an active lifestyle.
• It may help to go back and read “Get the Facts.” Surgery with physical rehabilitation offers the best chance to have a stable knee and an active lifestyle.

• You are right. If you’re willing to do several months of rehab first, you might want to try it before surgery.
• Sorry, that’s not right. If you’re willing to do several months of rehab first, you might want to try it before surgery.
• It may help to go back and read “Get the Facts.” If you’re willing to do several months of rehab first, you might want to try it before surgery.

• You are right. If you wait too long to fix a torn ACL and you start to get chronic ACL deficiency, the surgeon may not be able to fix all of your joint damage.
• Sorry, that’s not right. If you wait too long to fix a torn ACL and you start to get chronic ACL deficiency, the surgeon may not be able to fix all of your joint damage.
• It may help to go back and read “Get the Facts.” If you wait too long to fix a torn ACL and you start to get chronic ACL deficiency, the surgeon may not be able to fix all of your joint damage.

How sure do you feel right now about your decision?

Use the following space to list questions, concerns, and next steps.

Looking After Your Knee Replacement

Your new knee will continue to improve for as much as two years after your operation as the scar tissue heals and you exercise your muscles. You’ll need to look after yourself and pay attention to any of the following problems:

Stiffness Sometimes the knee can become very stiff in the weeks after the operation for no obvious reason. Try placing your foot on the first or second step of the stairs, hold on to the banister and lean into your knee. This should help to improve movement and flexibility in your knee. Its very important to continue with the exercises you were working on in the hospital.If the stiffness doesnt improve after about six weeks your surgeon may need to move or manipulate your knee. This will be done under anaesthetic.

Pain Pain caused by bruising from the operation is normal in the first two months, and you’ll probably still need to take painkillers at six weeks to help you sleep through the night. You may still have some pain for as long as six months. If you still have pain after this, speak to your physiotherapist or GP.

Infection You should speak to your GP or hospital if you notice any signs of infection, for example:

• breakdown of the wound with oozing/pus or sores
• increased pain
• redness and the affected area feeling warmer than usual or smelling unpleasant.

You should also look after your feet see a doctor or podiatrist if you notice any problems such as ingrown toenails that could become infected.

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Reasons For The Procedure

Knee replacement surgery is a treatment for pain and disability in theknee. The most common condition that results in the need for kneereplacement surgery is osteoarthritis.

Osteoarthritis is characterized by the breakdown of joint cartilage.Damage to the cartilage and bones limits movement and may cause pain.People with severe degenerative joint disease may be unable to donormal activities that involve bending at the knee, such as walking orclimbing stairs, because they are painful. The knee may swell or”give-way” because the joint is not stable.

Other forms of arthritis, such as rheumatoid arthritis and arthritis thatresults from a knee injury, may also lead to degeneration of the kneejoint. In addition, fractures, torn cartilage, and/or torn ligaments maylead to irreversible damage to the knee joint.

If medical treatments are not satisfactory, knee replacement surgery may bean effective treatment. Some medical treatments for degenerative jointdisease may include, but are not limited to, the following:

• Anti-inflammatory medications

• Cortisone injections into the knee joint

• Viscosupplementation injections

• Weight loss

There may be other reasons for your doctor to recommend a knee replacementsurgery.

It Will Slow Down Your Recovery Process

If your activity levels drop due to chronic pain or you find yourself wheelchair-bound as a result of osteoarthritis, the muscles in your legs may begin to deteriorate. Muscle mass already declines with age, so by further reducing your activity levels, you may experience compound effects that slow down your physical recovery. It could also make post-operative recovery procedures, like physical therapy, all the more challenging.

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Request Dental Clearance Before Surgery

More and more surgeons are requiring that their patients get clearance from their dentist before hip and knee replacements to help decrease the risk of pre-existing infection traveling to the surgical site. If present, bacteria from a dental disease most often gum disease or periodontitis can transfer from the mouth to the vulnerable tissues affected by the surgery.

Nearly 50% of adults in the United States today have some degree of periodontal disease, according to the CDC. And this amount is even higher among adults over the age of 65, the same age group which commonly undergoes joint replacement intervention. Yet, the majority of people dont realize that they have the condition. Many patients have no pain or noticeable symptoms until the disease is in the advanced stages of development. A comprehensive dental screening is the only way to be sure your mouth is free of this bacteria.

The ADA recommends that patients get a dental examination and clearance from their dentist prior to elective surgeries. If gingivitis and periodontal bacteria is detected, treatment often includes oral antibiotics and a simple, non-invasive procedure to remove tartar and bacteria from the teeth. Proper treatment may require briefly postponing the joint surgery, but it will help ensure a positive outcome, faster recovery, and better health in general.

When To Consider Knee Replacement Surgery

A doctor can present knee replacement surgery as a treatment option, but whether or not to have the surgery is up to the patient. Some patients choose to have knee replacement surgery as soon as their doctors suggest it. Others want to avoid surgery or postpone it as long as possible.

People considering knee replacement are advised to consider 3 questions: How does knee pain affect lifestyle? Have other treatments been exhausted? and What are the risks related to not having surgery?

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