Knee replacement

Preparation is crucial for a successful knee replacement surgery. The process begins well before the surgery itself and includes several essential steps to ensure you are physically and mentally ready for the procedure.

Comprehensive evaluation:

Before your surgery, the doctor will conduct a thorough examination of your knee and medical history. This may include:

• Physical examination: The doctor will check your knee’s range of motion, alignment, and function.
• Diagnostic imaging: X-rays or MRIs are done to assess the extent of the joint damage and plan for the type of prosthetic implant needed.

Pre-surgery tests:

You’ll undergo a series of tests to ensure your body is prepared for surgery and that there are no underlying health issues:

• Blood tests: To check for anemia, infection, and overall health markers.
• Heart evaluation: An electrocardiogram (EKG) and possibly other tests to assess heart function.
• Urinalysis and other health screenings: To identify potential infections or conditions that might complicate surgery.

Lifestyle adjustments:

Leading up to surgery, you’ll be encouraged to make certain lifestyle adjustments to promote better recovery:

• Weight management: Maintaining a healthy weight reduces stress on the knee joint and improves the outcome of the surgery.
• Smoking cessation: Smoking interferes with healing and increases the risk of complications, so it’s strongly recommended that you quit smoking before surgery.
• Strengthening exercises: You may be prescribed physical therapy or exercises to strengthen the muscles around your knee and improve flexibility, which will aid in your post-surgery recovery.

Patient education:

Understanding the procedure and recovery process is crucial for setting expectations:

• Counseling on surgery: Your surgeon or a nurse will explain the surgery in detail, what will happen during the procedure, and what the expected outcomes are.
• Post-surgery care: You’ll be briefed on pain management, mobility aids (like crutches or walkers), and rehabilitation exercises you’ll need to perform after surgery.
• Recovery timeline: Information will be provided on the typical recovery journey, what to expect in the weeks and months following surgery.

Knee replacement surgery typically takes between 1-2 hours. The procedure involves removing damaged tissue and replacing it with a prosthetic joint. Here’s a breakdown of what happens during the surgery:

Anesthesia:

• General anesthesia: You will be asleep throughout the surgery and will not feel any pain.
• Spinal anesthesia: Alternatively, a spinal block may be used, numbing the lower half of your body while you remain awake but relaxed.

Surgical procedure:

Once you are properly anesthetized, the surgical team will proceed with the following steps:

• Incision: The surgeon will make an incision on the front of your knee, typically between 6 to 8 inches long, to access the knee joint.
• Removal of damaged tissue: The surgeon removes the damaged cartilage and bone from the femur (thigh bone) and tibia (shin bone) to prepare for the prosthesis.
• Implantation of the prosthetic joint: The surgeon then positions the metal and plastic components of the prosthesis. The components are designed to fit together, replicating the natural motion of the knee joint. The femur and tibia are reshaped to fit the artificial components, and the patella (knee cap) may also be resurfaced.
• Securing the prosthetic: The artificial parts are carefully secured in place, and the alignment of the knee is checked to ensure the joint moves as naturally as possible.
• Closing the incision: Once the prosthesis is securely in place, the incision is closed with stitches or staples, and a sterile dressing is applied to reduce the risk of infection.

Post-operative monitoring:

After surgery, you will be closely monitored in the recovery room to ensure your vitals are stable and to manage any immediate post-surgery concerns:

• Pain management: Medications will be administered to control pain and swelling.
• Vital signs monitoring: Your blood pressure, heart rate, and oxygen levels will be checked regularly.

You will remain in the recovery room until you are stable enough to be transferred to a hospital room.

The recovery process begins as soon as your surgery is complete. While the road to full recovery can take months, your knee will start healing immediately after the procedure.

Recovery in hospital:

In the hospital, you will stay for 1-3 days, depending on your health and how well you are recovering. During your stay:

• Pain management: Your healthcare team will help manage any pain with medications, which may include opioids, anti-inflammatory drugs, or nerve blocks.
• Monitoring: Your doctors and nurses will monitor your progress to prevent complications, such as blood clots or infections.
• Initial rehabilitation: The first steps of rehabilitation begin right away. Nurses or physical therapists will help you move your leg and get out of bed. Early movement is crucial to prevent complications and improve circulation.

Physical therapy:

One of the most important aspects of your recovery is physical therapy, which begins as soon as you are able to move after surgery:

• Early exercises: These exercises are focused on strengthening the muscles around the knee, improving flexibility, and increasing the range of motion. These exercises are crucial for regaining mobility.
• Walking aids: You will likely be given a walker or crutches to help you move around. A physical therapist will teach you how to use these aids properly.

Your therapy may be done in the hospital and continue at home or an outpatient facility once you are discharged.

Long-term recovery:

Most patients can return to light activities, such as walking short distances or doing light chores, within 6 weeks after surgery. However, full recovery typically takes 3-6 months. Here’s what you can expect during this time:

• Gradual return to activity: As you build strength and flexibility, you will be able to return to more normal activities. You may even be able to resume low-impact exercises such as swimming, cycling, or walking.
• Full mobility: By 3-6 months post-surgery, most patients have regained full knee function, with the ability to walk without pain and perform daily activities.
• Ongoing therapy: Physical therapy may continue for several weeks after surgery to improve strength and mobility further. Your therapist will guide you on specific exercises to maximize the benefit of the surgery.