The majority of total knee replacement patients are over the age of 50. Your doctor may refer you to an orthopaedic surgeon for a thorough evaluation to determine if you might benefit from this surgery. What is the recovery period after knee replacement surgery? The incision should then be covered with a clean, dry bandage. If you have severe pain, consult with your surgeon as soon as possible. Examine the patellofemoral track with care if you have a clunk or crepitus. The most common type of scan is a triple-phase technetium 99-m-HDT bone scan, and the most common type of leukocyte scan is a indium-111 scan. Some questions to consider asking your knee surgeon: A large hospital usually with academic affiliation and equipped with state-of-the-art radiologic imaging equipment and medical intensive care unit is clearly preferable in the care of patients with knee arthritis. Some patients whose physical condition doesnt permit the aggressive therapy program that inpatient rehabilitation units pursue may instead elect to have a short stay at an extended-care facility. The absorptive capacity and permeability of the dressing determine its ability to provide a moist environment for TJA incisions. Box 356500 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. It is quite likely that you know someone with a knee replacement who walks so well that you dont know (s)he even had surgery! However, inflammatory arthritis patients who decide to have total knee replacement have an extremely high likelihood of success. Certainly people who are physically fit are more resilient and, in general, more able to overcome the problems associated with arthritis. Patients undergoing total knee replacement surgery usually will undergo a pre-operative surgical risk assessment. When necessary, further evaluation will be performed by an internal medicine physician who specializes in pre-operative evaluation and risk-factor modification. Current evidence suggests that when total knee replacements are done well in properly selected patients success is achieved in the large majority of patients and the implant serves the patient well for many years. Hip ABD/Adduction. Dressing with gauze with tape is the cheapest option, but it may not be the most cost-effective option. Research AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. Surgeons will often spend time with the patient in advance of the surgery, making certain that all the patient's questions and concerns, as well as those of the family, are answered. The success of your surgery will depend largely on how well you follow your orthopaedic surgeon's instructions at home during the first few weeks after surgery. It is important that patients with these conditions be followed by a qualified rheumatologist as there are a number of exciting new treatments that may decrease the symptoms and perhaps even slow the progression of knee joint damage. It is not possible to distinguish mechanical loosening from septic loosening on a standard x-ray. Regardless of whether a traditional total knee replacement or a minimally-invasive partial knee replacement (mini knee) is performed the goals and possible benefits are the same: relief of pain and restoration of function. Knee replacement surgery was first performed in 1968. It is expected that most patients will be able to nearly fully straighten the knee and bend it sufficiently to climb stairs and drive a car after having it replaced. Patients with morning stiffness of the knee may notice some improvement in knee flexibility over the course of the day. Minor infections in the wound area are generally treated with antibiotics. In the J. Pediatr. Generally speaking patients with inflammatory arthritis (like rheumatoid arthritis or lupus) and patients with diffuse arthritis all throughout the knee should not receive partial knee replacements. Although you will be able to walk with a cane, crutches, or a walker soon after surgery, you will need help for several weeks with such tasks as cooking, shopping, bathing, and doing laundry. Each knee has two rings of cartilage called "menisci" (this is the plural form of "meniscus"). Deep closures in the past, such as interrupted, knotted closures, have been performed. The use of either sutures or staples for skin re-approximation remains a contested subject, which may have a significant impact on both patient safety and surgical outcome. The new surgical approach which uses a much smaller incision than traditional total knee replacement significantly decreases the amount of post-operative pain and shortens the rehabilitation period. During the initial surgery, the implant was either cemented into the bone or press-fit to allow bone to grow onto the surface of the implant. Aggressive rehabilitation is desirable following this procedure and a high level of patient motivation is important in order to get the best possible result. Dressings keep the wound at a comfortable core body temperature, which boosts the rate of miotic cell division and leukocyte activity. A post hoc power analysis was performed to determine the difference in surgical time between the two treatment groups. Recommendations for surgery are based on a patient's pain and disability, not age. The ends of these three bones are covered with articular cartilage, a smooth substance that protects the bones and enables them to move easily within the joint. Seven patients with a partial tear were treated nonoperatively, and all had a satisfactory outcome. TKA is best suited to people who reach the age of 70 or 80. Straight leg raises: Tighten your thigh. If not treated promptly knee infections can cause rapid destruction of the joint. This is needed to make sure you are healthy enough to have the surgery and complete the recovery process. Following discharge from the hospital most patients will take oral pain medications--usually Percocet Vicoden or Tylenol #3--for one to three weeks after the procedure mainly to help with physical therapy and home exercises for the knee. These researchers argue that TKA should be performed between the ages of 70 and 80 due to the high risk of heart failure in this age group. Although uncommon, when these complications occur, they can prolong or limit full recovery. An evaluation with an orthopaedic surgeon consists of several components: (Left) In this x-ray of a normal knee, the space between the bones indicates healthy cartilage (arrows). Dissolvable stitches are placed under the skin to close the wound. The act of kneeling can be uncomfortable at times, but not harmful. Looked strange - and all of a sudden, it wasn't there any more! It is common for patients to have shallow breathing in the early postoperative period. Two to three therapy sessions per week are average for this procedure. An Asian old lady patient shows her scars from a total knee joint replacement surgery arthroplasty, which she had on bed in a nursing home. This is a natural part of the healing process. It may even occur years later. If a patient has arthritis of the knee it will be evident on routine X-rays of the joint. For those who are considering a knee replacement, there is a lot to think about. But disease or injury can disrupt this harmony, resulting in pain, muscle weakness, and reduced function. The motion of your knee replacement after surgery can be predicted by the range of motion you have in your knee before surgery. All material on this website is protected by copyright. For younger patients (typically under age 40 but this age cutoff is flexible) who desire to return to a high level of athletic activity or physical work a procedure called osteotomy (which means cutting the bone) might be worth considering. Discuss your concerns thoroughly with your orthopaedic surgeon prior to surgery. Most patients are back to full activities--without the pain they had before surgery--by about three months after the operation. The long thigh muscles give the knee strength. Because of its occlusive nature, some advanced wound dressings have been shown to reduce blistering. Turned out it was about 1/4" long and the bottom was dissolved; the top part that was sticking out had not dissolved. About OrthoInfoEditorial Board Our ContributorsOur Subspecialty Partners Contact Us, Privacy PolicyTerms & Conditions Linking Policy AAOS Newsroom Find an FAAOS Surgeon. It is important to use opioids only as directed by your doctor. Major medical complications such as heart attack or stroke occur even less frequently. Position the metal implants. Thats why it doesnt work well if more than one compartment of the knee is involved--in those patients there is no good place through which the load can be redistributed. If you decide to have total knee replacement surgery, your orthopaedic surgeon may ask you to schedule a complete physical examination with your doctorseveral weeks before the operation. Rotator Cuff and Shoulder Conditioning Program. Infection. Treatment is more complicated if the infection has been present for a long time . Your new knee may cause metal detectors in some buildings and airports to detect metal. It is sometimes used for severe infections of the knee certain tumors and patients who are too young for joint replacement but are otherwise poor candidates for osteotomy. Most surgeons will recommend that the initial bandage be left in place for 24 to 48 hours after surgery. Find a Clinic Once the damaged tissue is removed, the surgeon will insert metal implants to replace the lost bone and a plastic or metal spacer to replace the lost cartilage. It is important to learn as much as possible about the condition and the treatment options that are available before deciding whether--or how--to have a knee replacement done. The large majority walk without a limp and most dont require a cane, even if they used one before the surgery. For more information:Surgical Management of Osteoarthritis of the Knee - Clinical Practice Guideline (CPG) | American Academy of Orthopaedic Surgeons (aaos.org). Follow your orthopaedic surgeon's instructions carefully to reduce the risk of blood clots developing during the first several weeks of your recovery. Patients are encouraged to walk and to bear as much weight on the leg as they are comfortable doing. In general, however, most patients require between 10 and 20 stitches to close the incision.