Should You Consider a Knee Replacement?

Is your knee pain interfering with everyday life? If other methods of pain relief aren’t working, it may be time to talk to your doctor about knee replacement surgery. Also called arthroplasty, knee replacement surgery is generally for people over the age of 50 with severe osteoarthritis. It involves capping the ends of the bones that form the knee joint, as well as the knee cap, with metal and plastic parts.

What are some of the primary reasons knee replacement surgery might be right for you, and what can you expect both before and after? Let’s take a look.

Reasons for Knee Replacement

The primary reason for knee replacement surgery is osteoarthritis that becomes extremely painful. Osteoarthritis involves the breaking down of joint cartilage, which limits movement and causes pain. In many cases, this makes simple tasks like walking or climbing stairs extremely painful.

Other forms of arthritis can also lead to knee replacement, including rheumatoid arthritis or arthritis resulting from an injury. Traumas like fractures, torn cartilage and torn ligaments may also lead to knee replacement surgery. In most cases, surgery will only be considered a serious option after other less invasive treatment methods have failed.

What to Expect

Before a knee replacement procedure, you will need to complete several steps to prepare:

Sign a consent form (read this carefully, and ask any questions you may have before signing)
In some cases, your doctor will perform a physical exam and/or blood tests or other diagnostic tests
Notify the doctor of any medication allergies and any medications you regularly take
Notify your doctor if you have a history of bleeding disorders or are taking any medications that affect blood clotting
If you’re pregnant or suspect you may be pregnant, tell your doctor
Fast for eight hours prior to the procedure (usually after midnight)
Arrange for help around the house for a week or two after the procedure
Speak to a physical therapist about rehab
In some cases, you’ll receive a sedative for relaxation

During surgery, you’ll be put under general anesthesia or spinal/epidural anesthesia (numb below the waist), and a cut between 8 and 12 inches will be made in front of the knee. The damaged section of the joint is removed from the bone surface, and the surfaces are then shaped in preparation for an artificial joint. This joint (called a prosthesis), made of metal or plastic, is attached to the thigh bone, shin and kneecap with cement or a special material. Then the incision will be closed with stitches or staples, and a bandage will be applied.

Risks and Recovery

There are a few risks associated with knee replacement surgery:

Blood clots: Your doctor will give you blood thinners to help with this
Bleeding and infection
Loosening or breaking of the prosthesis
Continued pain
Pieces of fat in bone marrow loosening and entering the lungs, causing breathing issues (rare)
Numbness in nerves in the knee (rare)
Other broken bones during surgery (rare)

For current knee replacement surgeries, about 85 percent of implants last at least 20 years. There are recent advances in minimally invasive surgery that limit the size of the incision and can lead to even less pain and quicker recovery times, but only a small number of North American surgeons perform this procedure currently while more research is being done on it.

Recovery after knee surgery can include changes around the home and physical therapy. With the right recovery tactics, you can return to many or all of the same activities as before surgery.

If you think knee replacement surgery might be right for you, speak to your doctor and he or she will determine the most appropriate course of treatment, based on your specific diagnosis.