Total knee replacement is also called total knee arthroplasty. It involves removing and replacing your knee joint. The knee joint is where your femur (thigh bone) and tibia (large lower leg bone or shin bone) meet. A small triangular bone called the patella (kneecap) protects your knee joint. Arthritis, Paget’s disease, hemophilia, or an infection can damage your knee joint. Surgery to fix a fractured femur can also damage your knee joint. Avascular necrosis is a condition that occurs when blood cannot flow well to certain body areas, causing bones to weaken. This can also harm your knee joint. These conditions may cause knee pain and limit your activities. You may still have knee pain after 3 to 6 months of treatment. Your knee pain may be so bad that you cannot sleep. If you have any of these problems, you may benefit from total knee replacement.
At Memorial Health Bone & Joint, we want you to be informed and prepared for your surgery. You and a loved one or caregiver will be asked to attend a pre-surgical class. The classes are held every week at Memorial University Medical Center.
You will be given a handbook detailing appointments, pre-surgical testing, and preparations you should make at home.
The Surgical Process
You will receive anesthesia to ensure that you do not feel anything. Your surgeon makes an incision (cut) into your knee. Your kneecap is removed. Your tendons and leg muscles are moved to the side. In some cases, the surgeon may need to cut into a tendon or muscle. The damaged parts of your femur and tibia are removed. Rough areas in your knee may be made smooth. Your surgeon will measure, prepare, and place the implants in your knee. He may secure the implants using screws or special cement. The kneecap, muscles, and other tissues around the joint will be moved back into place. A thin rubber tube may be placed on your skin to drain blood and other fluids away from your knee. The cut will be closed with stitches or staples.
Some patients require bilateral joint replacement. This is the process of replacing both knees at once. Our surgeons perform this procedure as well.
You will be taken to a recovery room, where you will stay until you are fully awake. Caregivers will watch you closely to ensure you do not have any complications. Do not try to get out of bed until your caregiver says it is ok. You will be asked to use an incentive spirometer (special device) to help improve how your lungs work. When caregivers see that you are awake you will be taken to your hospital room. You will have a bandage on your knee to keep the area clean and help prevent infection. A caregiver will change the bandage and check your knee. An X-ray of your knee may also be done. You may need to use a continuous passive motion (CPM) machine. This machine will slowly bend and straighten your knee for you as you lie in bed. A cast or splint may be placed on your leg. Caregivers may help you get out of bed to begin walking very soon after surgery.
You will receive pain medication as needed and will begin physical therapy.
Discharge and Follow Up
The average hospital stay after joint replacement surgery is two days. You will be asked to follow up with your surgeon within 10 to 14 days. Because every person’s body is different, you may require a longer hospital stay. You will be given specific guidelines to follow at home.
Physical and occupational therapy will continue for four weeks. Your physical therapist will teach you to use a walker and help you increase your mobility and movement through exercise. Your occupational therapist will help you learn how to perform daily activities such as dressing, bathing, and simple household tasks. For your therapy, you can visit The Rehabilitation Institute at Memorial Health University Medical Center, contact a different facility, or arrange to have a therapist come to your home.
Recovery and Moving On
Recovery after joint replacement surgery is a steady but gradual process. Most people use a walker for four weeks. They can drive a car within six weeks. They can dance slowly within six to eight weeks, and play golf, doubles tennis, shuffleboard, and bowl within 12 weeks. More strenuous sports, such as singles tennis and jogging, are not recommended after joint replacement. Keep in mind that healing and recovery times vary with each person. Your physician and therapist can help you decide when you’re ready to begin new tasks.
Joint replacement is considered a miracle of modern surgery. Most orthopaedic experts consider replacement to be the best method of handling advanced arthritis or other damage in the knee. Joint replacements have literally put hundreds of thousands of Americans back on their feet.