Navigating a Knee Replacement

The days of sitting on the sofa and growing old have vanished. Middle-aged and older adults increasingly demand an active and healthy lifestyle. But dealing with the inevitable aches and pains of aging can prove frustrating, especially when they keep you from doing the activities you love. Knee pain is a prime culprit. As a result, a growing number of individuals are considering knee replacement surgery.

More than 90 percent of individuals who receive a knee replacement experience a dramatic decrease in pain. However, the path to health can prove somewhat challenging. If you decide that a knee replacement is right for you, there’s a long and complex process ahead: planning, undergoing, and recovering from the procedure. 

It’s critical to understand treatment variations along with the associated risks and benefits of a procedure. You will also want to know what questions to ask and what you can do before surgery in order to make it a success. When you enter the operating room, you’ll want to know what will happen during the operation and what to expect during your time at the hospital. And, afterward, you’ll want to know what’s necessary for a quick and successful recovery and what it’s like to live with an artificial knee. 

That’s where this guide can help. It’s designed to provide a comprehensive overview of knee replacement surgery—from making the decision about whether the procedure is right for you and deciding which surgeon and device to use, to managing your recovery and rehabilitation in the best possible way. Regardless of what stage of the process you are in, there are many important decisions to make and steps to take before you can go back to participating in daily activities relatively pain-free. 

Here’s a typical framework for a knee replacement surgery. Of course, the exact point that any activity or action takes place depends on your specific circumstances and the speed at which you make decisions.

Considering Knee Replacement

It is not uncommon for knee replacement candidates to spend months or even years considering surgery. It’s a serious decision and it’s important to make the right choices. During this time, it is important to consider various issues and factors. This guide provides you with the information you need to engage in a serious and productive conversation with a surgeon and discuss your surgical options.

A starting point is to understand what’s involved with the process. Here are key issues that you must address before undergoing a total knee replacement:

Assess Your Pain

  • What is the cause of my knee pain? 
  • How bad is the knee pain? What effect is it having on my life?

Options

  • What treatment options exist? Do viable alternatives to surgery exist? Have I explored or tried them?

Learn About Knee Replacement

  • What takes place during surgery?
  • What can I expect from surgery and what outcomes are possible? What do other patients who have undergone a knee replacement say about it?
  • What surgical variations exist?

Evaluation & Timing

  • Am I a candidate for a knee replacement? What will happen at an evaluation?
  • What questions should I ask?
  • Is this the right time to undergo knee replacement?

Preparing for Surgery

Once you have decided that surgery is the right option, you will need to consider several critical questions. At this point, the choice of a surgeon and particular type of surgery may still be up in the air. You will also want to consider the quality of the hospital where the surgery will be performed.

Here are some questions that you may want to consider :

  • How do I choose my surgeon? How do I know he or she is the right one? What questions should I ask?
  • What type of procedure and implant is best for me? Why is my surgeon recommending these options? How does the implant work?
  • What are the risks and possible complications with surgery?
  • What can I expect during my time at the hospital and after surgery?
  • What are the costs? Am I prepared to cover these expenses? What should I find out from the insurance company or Medicare and what should I ask the surgeon and hospital?
  • What are the track records for the surgeon and the hospital?

Once you and your surgeon have agreed on a procedure, your timeline becomes more predictable. It will look something like this:

2-3 Weeks Prior to Surgery

  • Pre-operative planning: During this time, your medical team will study your history and knee in order to clear you for surgery and prepare for the operation.
  • Exercise: Your surgeon may prescribe exercises to strengthen muscles prior to surgery.
  • You may want to get answers to these key questions during this time:
    • What medications will I take? How will I manage the pain?
    • What activities will I need to perform (standing, walking, etc.) before the hospital will discharge me?
    • What will I need to do to my home in order to function effectively during my recovery? What type of assistance will I require?
    • What physical therapy facility will I use? Will a physical therapist come to my home?

1-2 Weeks Prior to Surgery

  • Preparation course: This is usually offered by the hospital prior to the surgery.
  • Final consultation with surgeon: This serves as an opportunity to ask any last-minute questions about the procedure or medications.
  • Final tests and diagnostics: These ensure that you are fit enough to undergo surgery.
  • Prepare your home for your recovery. Make sure you’ve got the right equipment and setup so that you can manage when you go home.
  • Make arrangements with your employer for the time-off.
  • Make sure you have a caregiver. Double check that you have the help you need when you return home and that this person understands his or her role. If you will not have a caregiver at home, be sure to work with your surgeon’s office to arrange that you go to a rehab facility.

Surgery

Surgery and post-op recovery is a challenging time. The average total knee replacement  patient will stay in the hospital three to four days. Your surgery will occur on day one. You will be encouraged to stand on your artificial knee as soon as possible; you will work with a physical therapist in the hospital, and you will most likely be expected to be able to walk with a walker on the day of discharge. During and after your stay at the hospital, you must understand several key things:

  • Post-surgery trauma: You must manage pain, new sensations, swelling, and bruising.
  • Know your overall rehab plan. You must commit to a rehabilitation plan and manage the daily task of doing exercises.
  • Know your exercises. Understand the daily exercises and treatments you will be required to do.
  • Understand your follow-up schedule. You will have doctor appointments and physical therapy sessions at regular intervals.
  • Post-surgery “Dos and Don’ts:” You will need to know what to do and what not to do when you receive your artificial knee.

Recovery and Rehabilitation

Once you are at home, your focus will become the goals of your rehabilitation and regaining your ability to engage in the activities you enjoy. While each person recovers at a different pace, rehabilitation generally follows a 12-week timeline with specific goals each week that you can work with your physical therapist to set. This ensures that you’re learning to use your new knee properly and you are achieving appropriate physical goals, such as improving your range of motion. Physical therapy and exercises are paramount during this period. Your rehab timeline will look something like this:

Week 1

Begin in-home rehabilitation under the guidance of a physical therapist.

Week 3

Walk and possibly drive on your own.

Week 4-5

Return to work and low-impact activities such as walking, swimming, and bicycling.

Week 6-11

Become more active. Your physical therapist may adapt your exercises to fit your growing strength and increasing activity level.

Week 12

Your life should seem much more normal. You will likely be able to resume a wide range of activities and experience a dramatic decrease in pain.

Living with an Artificial Knee

Once you get through rehab, the most difficult part is over—however, life with an artificial knee will always be different. It’s essential to know how the new knee will change your life and how to get the most out of it—so that you can engage in typical activities pain-free.

Key questions include:

  • What sports and activities can I perform safely?
  • What is the new “normal”? What will my daily life be like?
  • What can I do to get the most out of this knee? What role do vitamins and supplements play? How important is managing my weight?
  • How can I maintain a healthy state of mind?
  • How do I know if the artificial knee is working as it should? What if something goes wrong? What happens if the stiffness persists?

Knee replacement surgery can dramatically improve the quality of your life. The time and energy you spend researching options, preparing for the surgery, and managing recovery and rehabilitation will pay dividends. Use this guide to help you make the right decisions and, if you require surgery, get the most out of your artificial knee. An active and healthy lifestyle can transform your life.