What to Expect When You're Expecting: Total Knee Replacement

 

What to Expect When You're Expecting: Total Knee Replacement

In my 12 years of working in the outpatient physical therapy world, I've treated hundreds of people following a total knee replacement. I would venture to guess that 90%, or more, are surprised by how difficult the first couple weeks post-operative can be. Millions of people undergo this procedure each year to relieve chronic knee pain and regain mobility. While the thought of surgery might be a bit nerve-wracking, understanding what to expect throughout the process can prepare you for a successful outcome.

Understanding the Procedure

A total knee replacement involves replacing the damaged parts of your knee joint with artificial implants. This surgery is typically recommended for people with severe arthritis that no longer responds to non-surgical treatments like medication or physical therapy.

Preparing for Surgery

Before your surgery, you'll have consultations with your doctor to discuss your medical history, perform a physical examination, and order imaging tests like X-rays or MRIs to assess the condition of your knee joint. Your doctor will also provide specific instructions, which might include:

• Blood tests to ensure you're healthy enough for surgery.
• Adjusting or stopping certain medications that could interfere with anesthesia or bleeding.
• Starting physical therapy exercises to strengthen the muscles around your knee, which several studies have shown will aid recovery.

Surgery Day and Hospital Stay

On surgery day, you'll likely receive either general anesthesia (completely asleep) or spinal anesthesia (numbness below the waist). The surgery itself usually takes a couple of hours. After surgery, you'll be monitored in a recovery room before being transferred to your hospital room.

Pain management is a priority after surgery. Your doctor will prescribe medication and employ techniques like ice packs to keep you comfortable. Physical therapy will also begin shortly after surgery, focusing on gentle exercises to improve flexibility and range of motion in your new knee. Your hospital stay depends on multiple factors, including your surgeon, your recovery, if you've had a previous replacement, etc. Some surgeons allow you to go home the day of surgery! Many patients stay at least one night in the hospital, with some staying a few days longer.

Recovery at Home

Following discharge from the hospital, recovery continues at home. Physical therapy is crucial during this stage. A therapist will guide you through exercises to strengthen your leg muscles, improve your gait, and restore mobility in your knee. Pain management will likely involve medication and possibly cryotherapy (ice) as recommended by your doctor.

Minor home modifications can significantly improve your comfort and safety during recovery. Consider installing grab bars in your bathroom, using a shower chair, or raising your toilet seat.

What is My New Knee Made of?

A total knee replacement is comprised of several components, each made from different materials to optimize durability, functionality, and biocompatibility:

• Metal Alloys: The femoral component, which replaces the lower end of the thigh bone, is typically crafted from cobalt-chromium or titanium alloys. Cobalt-chromium is highly scratch-resistant and commonly used, while titanium offers a lighter weight but might be less wear-resistant.

• Medical-Grade Polyethylene: The tibial component, replacing the top surface of your shinbone, usually consists of a metal tray for stability and a liner made from ultra-strong and wear-resistant polyethylene. This plastic offers a smooth, low-friction surface for articulation within the joint.

• Optional: Ceramics: In some cases, implants might utilize ceramics, like zirconium oxide, for the bearing surface. These are particularly wear-resistant but may come with a higher cost and potential for increased brittleness.

Long-Term Recovery and Outlook

While everyone recovers at their own pace, most people experience significant pain relief and improved mobility within a few weeks to months following surgery. Regaining full strength and flexibility can take up to a year. It's important to be patient and consistent with your physical therapy exercises.

As with any surgery, there are potential risks and complications associated with knee replacement. Be sure to discuss these with your doctor in detail. The good news is that total knee replacement surgery has a high success rate, and for many people, it dramatically improves their quality of life by allowing them to participate in activities they may have had to give up due to knee pain.

Taking Charge of Your Recovery

If you're considering knee replacement surgery, remember that knowledge is power. Talk openly with your doctor and physical therapist about your questions and concerns. Following their guidance and diligently performing your physical therapy exercises are essential for a successful recovery. With preparation and a positive attitude, you can look forward to a future with renewed mobility and freedom from chronic knee pain.

Thanks for reading!