Knee Replacement Surgery: What to Expectدکتر نیما محسنی
Knee replacement surgery is one of the most common bone surgeries in the country. Whether you need the surgery is a decision that you and your doctor, an orthopedic surgeon, carefully make together. More than 90% of people who have had their knees replaced see a huge improvement in pain and their ability to get around.
Known as arthroplasty, knee replacement surgery replaces the damaged parts of your knee with artificial parts. Several million Americans live with such implants.
Deciding to Have Surgery
You might get surgery for a number of reasons:
- Severe pain and stiffness makes it hard for you to walk, climb stairs, or get out of a chair.
- Nagging knee pain bothers you while resting, possibly keeping you from sleeping well.
- Your knee is often swollen.
- Your knee is bowed or has other defects.
- Physical therapy and medication haven’t helped.
Preparing for Surgery
Before you have surgery, your surgeon will take your medical history and do a physical exam that includes X-rays and possibly blood tests. Your doctor will use those X-rays to figure out what the damage inside your knee looks like. The doctor will also want to see how strong the muscle support around your knee is, and how well you can move the joint.
As with all surgeries, tell your doctor what medications you are on, including blood thinners, aspirin, or other drugs. They’ll also need to know if you have a history of infections, bleeding, or blood clots. You also shouldn’t eat for 8 hours before the surgery.
Knee replacement surgery has become more advanced. If you are healthy, it can be done as an outpatient procedure without a hospital stay. If done in the hospital, expect to stay in the hospital for at least 1 to 4 days. Just before surgery, nurses might insert an intravenous line (IV) into a vein in your arm or hand to give you fluids and medicines. They also have to shave your skin where the doctor will make the cut.
You might get general anesthesia to put you in a deep sleep during the surgery. Your doctor may decide instead to give you a spinal/epidural anesthesia, which will numb you below the waist but keep you awake. Most people will have general anesthesia.
Surgery can take 1 to 2 hours. Your doctor can do it a couple of ways. They might make an 8- to 10-inch cut in the front of the knee. Then they’ll take out the damaged part of the joint and the surfaces of the thigh bone and shin next to the joint. Once that is done, the surgeon will implant the artificial knee.
You might get what’s called “minimally invasive” surgery. In this case, the surgeon will make a shorter cut, around 4 to 6 inches. This will result in less damage to muscle and tendon. A person who is thin, young, and healthy is usually a good candidate for this technique.
You can expect to be up on your feet within a day. That might be hard to do on your own at first. So you may need parallel bars, crutches, a walker, or a cane for a while to get up.
Usually, you can expect a big improvement in flexibility and much less pain within a month. It’s important to exercise your knee often, to keep down swelling and to strengthen your muscles.
You might need help from a physical therapist, who will go through a series of exercises to strengthen your repaired knee. How long you’ll need physical therapy depends on your health and how motivated you are to recover from your surgery.