Knee replacement surgery (knee arthroplasty) is a common surgical procedure in which damaged knee joint surfaces are replaced to restore function and relieve pain and disability. During knee replacement surgery, the damaged cartilage and bone is removed and the joint is resurfaced to hold replacement parts comprised of high-grade plastics, polymers, and/or metal alloys. If you are experiencing knee problems, such as difficulty walking, climbing stairs, or bending the joint, contact the orthopedic surgeons at OSMI Fort Worth to discuss your treatment options. At OSMI, we are committed to helping each patient achieve better orthopedic health by restoring functionality and quality of life through both surgical and non-surgical methods. Knee replacement surgery (knee arthroplasty) is an option at OSMI to treat knee injuries and disorders not responsive to medical treatment. OSMI provide knee replacement surgeons in Fort Worth.
Components of the artificial knee implant will be used to cap the ends of the thigh bone (femur) and shin bone (tibia), and a plastic spacer will be placed, to create a functioning knee joint. This artificial knee joint is cemented in place with special materials. The ligaments and muscles surrounding the new knee joint will give it support and assist in functions, such as rolling and gliding as the knee bends.
Reasons for Knee Replacement Surgery
The most common reason for knee replacement surgery is osteoarthritis, a degenerative joint disease which can cause the cartilage and bone in the knee to break down. Damage from osteoarthritis is typically caused by wear and tear to the cartilage (which acts as a cushion in the joints) over years. Ultimately, the bones rub against or closely to one another without the benefit of the shock-absorbing cartilage. Read more about osteoarthritis and exercise.
Symptoms of osteoarthritis of the knee can include:
- Decreased mobility
- Bone spurs
Anyone can develop osteoarthritis requiring knee replacement, however, it is more common in females over 45 years of age. Other factors which can contribute to needing knee replacement surgery include:
- Weight: Each pound of excess weight adds 3-4 pounds of pressure on the knees
- Heredity: Inherited abnormalities in knee bone shape or genetic mutations
- Stress injuries: Sports injuries or occupational activities, such as excessive kneeling, squatting, or lifting can damage the knee joint
Other conditions that may necessitate knee replacement surgery are:
- Rheumatoid arthritis: Immune system disorder in which the joints are attacked by the body itself, causing inflammation of the synovial membrane (connective tissue which lines the joints) and excessive synovial fluid
- Traumatic arthritis: Damage to the cartilage caused by an injury to the knee
- Fractures/torn ligaments or cartilage: Injuries that can cause irreversible knee joint damage
Knee replacement surgery will only be recommended if damage to the knee is severe and conservative medical treatments have been ineffective. Initial treatments may include:
- Anti-inflammatory and/or pain medications
- Weight loss (for those overweight)
- Physical therapy
- Glucosamine and chondroitin sulfate (supplement to aid in joint health)
- Cortisone injections in the knee (to alleviate pain and swelling)
- Viscosupplementation injections (for additional fluid lubrication and movement of the joint)
Patients are recommended for knee replacement surgery if they continue to have substantial pain after trying other medical treatments, or extensive damage is revealed, usually through the use of x-rays. Many often experience difficulty climbing stairs, sitting and rising from a chair, and even walking. Some patients suffer from knee pain while at rest, as well.
Benefits of knee replacement surgery include:
- Improved mobility
- Pain relief
- Better quality of life
Prior to Knee Replacement Surgery
Prior to recommending knee replacement surgery your orthopedic surgeon will complete a thorough medical examination. Your knee joint will be assessed for:
- Range of motion
- Extent of damage
- Pain level
Once your knee is evaluated, your doctor will make a recommendation on your treatment. Two factors will be used to determine if a patient is a good candidate for knee replacement surgery:
- Evidence and severity of damage to the existing joint
- Patient’s quality of life
Some patients needing minor repairs can often be treated with arthroscopic minimally invasive knee surgery. If the knee joint damage is beyond repair, your orthopedic surgeon will advise you on how to prepare and plan for knee replacement surgery and recovery.
Once your knee surgery is scheduled, you should plan ahead for your recovery to avoid additional stress after your procedure. You should arrange for someone to help you with everyday tasks after you are released from hospital, as you will likely be using crutches or a walker for a period of time.
Other helpful pre-planning tips for after knee replacement surgery include:
- Be sure everything you need is on one (bottom) floor since climbing stairs will be difficult
- Install handrails in the bath or shower
- Acquire a shower chair and toilet seat riser with arms
- Remove tripping hazards, such as electrical cords or loose rugs
Because bending and range of motion will be limited after surgery, acquiring items that will assist you with ordinary activities will aid in your speedy, stress-free recovery.
Helpful items include:
- Long-handled shoe horn, sponge, and shower hose
- Dressing stick
- Sock aid
- Reaching stick
Preparing your home prior to your knee replacement surgery will make it easier and safer to navigate once you are released from the hospital.
During Knee Replacement Surgery
During your knee replacement surgery, you will be given either general anesthesia or a spinal or epidural anesthesia so that you will be comfortable. Your anesthesiologist will monitor your vital signs including:
- Blood pressure
- Heart rate
- Blood oxygen level
During the knee replacement procedure, your orthopedic surgeon will make an incision (approximately 6-10 inches long) in the knee to expose the joint surfaces. The damaged surfaces are cut away and removed, and the prosthesis is attached with surgical cement.
The artificial knee joint is comprised of:
- Tibial component: Resurfaces the top of the shin bone
- Femoral component: Resurfaces end of thigh bone
- Patellar component: Resurfaces the bottom portion of the kneecap adjacent to the femur
Before the incision is closed (usually with surgical staples or stitches), your surgeon will test the new artificial knee joint by bending and rotating it to ensure functionality. You may receive a drain to remove fluid from the incision site. Knee replacement surgery typically takes approximately two hours to complete.
As with any surgery, knee replacement surgery involves some risk. Possible complications can include:
- Blood clots
- Wearing out or loosening of the prosthesis
- Continued stiffness or pain
In rare cases, an artificial knee joint may need to be replaced at a later time. All precautions will be taken to minimize the risk for any complications during or after knee replacement surgery.
After Knee Replacement Surgery
After knee replacement surgery, you will be observed and monitored in a recovery room for a short time until you are able to be moved into a hospital room. Knee replacement surgery typically requires a post-operative hospital stay of a few days. While in hospital, you will meet with a physical therapist to plan and begin your exercise program.
Benefits of beginning movement right away include:
- Increased blood flow
- Decreased swelling
- Minimized risk of blood clots
A continuous passive motion (CPM) machine which moves the new knee joint while you rest may be utilized. Pain medication will be administered to keep you comfortable as you begin to exercise your knee. Physical therapy will be an integral part of your recovery from knee replacement surgery.
Home Care After Knee Replacement Surgery
Your orthopedic surgeon will provide you with detailed instructions on how to care for your knee after surgery. It is important to be cautious after knee replacement surgery, as not to damage your new knee joint by falling. Physical activity should be resumed slowly and on a graduated basis.
Recovery from knee replacement surgery typically takes 3-6 weeks, and most patients are able to enjoy low-impact activities at that time. Until your orthopedic surgeon releases you to do so, you should avoid high-impact activities, such as:
- Contact sports
Contact your doctor if you experience any of the following symptoms after your knee replacement surgery:
- Drainage at the surgical site
- Increased swelling, redness, pain, or tenderness in the knee
Our goal at OSMI is to provide our patients quality, cutting-edge orthopedic treatments, both surgical and non-surgical. If you have questions about knee arthroscopy or surgery, knee joint pain, or physical therapy, please submit an online appointment request or contact our office at 817-529-1900.