Total knee replacement, or total knee arthroplasty, can decrease a patient’s pain and increase mobility. But, other treatment options may also help relieve pain without total knee replacement surgery. Our orthopaedic team can accurately diagnosis and treat the complete range of knee disorders, in some cases without surgery or the need for a total knee replacement.
If other treatment options have been tried, and pain persists, total knee replacement may be the best option. Our dedicated joint replacement team performs a high volume of knee replacement surgeries and has the experience and specialized skill to treat even the most challenging cases. We also have an excellent patient satisfaction rate and a low complication rate. Our focus is on delivering the best patient care possible.
Common Conditions That Can Lead to Knee Replacement
We treat the entire spectrum of knee problems. Many can be treated without surgery, but some may lead to partial or total knee replacement surgery, including:
- Osteoarthritis — Osteoarthritis is one of the leading causes of knee replacement. It is a chronic, degenerative condition, meaning it will continue to get worse over time. While there are many non-surgical treatment options, partial or total knee replacement may become necessary for some patients with osteoarthritis. Rheumatoid arthritis and post-traumatic arthritis can also lead to the need for knee replacement surgery.
- Avascular necrosis (bone death) — Avascular necrosis happens when the blood supply to the bone is cut off — temporarily or permanently. This can cause the bone tissue to die, which can affect nearby joints. If avascular necrosis affects the knee, a total knee replacement may be a treatment option.
Other Common Causes of Knee Pain
- Dislocations/complex instability
- Industrial conditions (work-related injuries)
- Torn cartilage/torn ligaments
When Is Total Knee Replacement Surgery Necessary?
The knee joint can be damaged by different types of arthritis, injury or trauma. Joints are formed when the ends of bone are connected by cartilage, which serves as a protective cushion. If the cartilage is damaged or tissues around the joint become inflamed or wear thin, the bones can rub against each other, causing pain. When pain makes even everyday activities difficult — like walking, climbing stairs, sitting or sleeping — total knee replacement may be an option.
How Does Total Knee Replacement Surgery Work?
During knee replacement surgery, joint surfaces are substituted or replaced by prostheses. After the damaged bone and cartilage is removed, the orthopaedic surgeon will place the new artificial knee in its place. For some patients, a minimally invasive approach may be appropriate, which requires smaller incisions and generally leads to faster recovery, less pain and fewer complications.
There are different types of knee implants, and they are typically made of metal alloys with ceramic and/or high-grade plastics. Generally, a knee implant includes components that replace the major parts of the knee (tibial, femoral and patellar components). It is secured in place with cement or screws. An artificial joint may last ten to 20 years. The type of implant used depends on the patient’s age, weight, medical conditions and other factors. As part of an academic medical center, we also have an implant bank on site that allows us to quickly deal with virtually any contingency.
Same-Day Discharge (Outpatient Knee Replacement)
More than half of our knee replacements are on an outpatient basis — meaning that you will go home the day of your surgery. Your surgeon will determine if this is an option for you based on your medical history and any other medical conditions you may have.
What to Expect During Knee Replacement Surgery
At home before your surgery, you will receive instructions on how to prepare for your surgery. This will include when to stop eating and drinking and when to arrive. Read the instructions carefully and contact your care team with any questions. If you take regular medication, ask your care team if you should take the medication or wait until after surgery. A responsible adult over the age of 18 will need to drive you home after surgery.
On the day of your surgery, you will arrive and check in. We will take you to a prep/recovery room to settle in. We will check your blood pressure, heart rate and other vitals. Your surgeon and the anesthesiologist will talk to you about the procedure and the anesthetic. We will start you on an IV. From there we will take you to the operating room.
After the surgery, we will take you back to the same room to monitor your recovery for approximately 4 – 6 hours. Our nursing team will monitor your vital signs, pain, nausea and hydration/drinking along with the progress of feeling coming back to your legs after the anesthetic. All of these things help determine your readiness to sit in a chair, walk and work with the physical therapist.
Once you are able, we will help you change into your own clothes and sit in a soft recliner chair. The nurse will discuss pain control prior to your physical therapy session to optimize your therapy experience. Here are the discharge criteria to meet prior to going home.
- Tolerate food and drink with minimal nausea
- Tolerable pain control level
- Be able to urinate
- Meet physical therapy goals during your therapy session
Once you have met these criteria, a nurse will review your discharge instructions with you and your responsible adult prior to discharge. Please feel free to ask any questions you have. The day after surgery, a staff member will call you to see how you are doing.
Inpatient Knee Replacement Surgery
Underlying medical conditions — such as a heart condition, history of stroke or another disease — can require that you stay in the hospital overnight or for a few days after surgery so that we can monitor your recovery. The surgeon or anesthesiologist could make the decision during surgery to keep you overnight or longer based on an observation during the procedure. The criteria for discharge are the same, but will take place over a longer period of time.
How Important Is Rehab After Knee Replacement?
Appropriate therapy and rehabilitation after knee replacement surgery helps restore a patient’s strength, mobility, function, range of motion and stability. Recovery usually takes about three months, but may take longer for some patients. Active participation in physical and occupational therapy is vital to a safe return to normal activities and independence.
Total Joint Replacement Class helps prepare patients for the many aspects of total knee replacement surgery. The class is held regularly and patients are encouraged to bring a relative or friend.