Osteoarthritis (OA) is the most common form of knee arthritis and can result in significant pain and disability. Symptoms are often worse with weight-bearing, and in advanced cases, even daily activities can become a challenge.
When movement and pain levels become too significant, knee replacement surgery may be an option.
Over 90 percent of people who undergo knee replacement surgery say it improves their pain.
There are different types of knee replacements. Options include:
- total knee replacement: the whole knee is replaced
- partial knee replacement: only the affected part of the knee is replaced
- bilateral knee replacement: both knees are replaced at the same time
In most cases, people have knee replacement surgery because they have OA. Total knee replacement is a very commonly performed operation. Every year, surgeons perform approximately 700,000 of them in the United States.
Most knee replacement surgery is performed under a combination of general anesthesia, peripheral nerve blocks, and spinal (epidural) anesthesia. You will also receive at least one dose of antibiotics to reduce the risk of infection.
During the procedure, the surgeon will remove bone and diseased cartilage from where your thigh bone (femur) and shin bone (tibia) meet at your knee joint.
Those surfaces are then replaced with a metal implant. A piece of special plastic is normally used to replace the backside of the kneecap and finally, this same plastic material is placed in between the two metal parts.
This gives both bones of your knee joint smooth surfaces again so they can flex and bend more freely and painlessly.
Most patients spend 2–3 nights in the hospital following a total knee replacement.
The doctor will prescribe pain medication and will monitor you for complications.
Shortly after your operation, a physical therapist will start helping with the following:
- weight-bearing therapy, including standing and walking
- a combination of physical and occupational therapy to help you adapt to your new knee
You will need to continue these exercises at home.
When you are able to perform certain tasks, such as getting out of bed alone and using the bathroom, you will be able to go home.
You may need to use a cane or walker for a short period of time after your operation.
Most of your recovery and rehabilitation will be at home after you leave the hospital. Some people need home health care or assistance.
Your doctor will most likely prescribe physical therapy at a local clinic for continued rehabilitation. The physical therapist at this clinic will suggest exercises you can do at home.
Everyone recovers differently, but most people are allowed to return to driving by the end of 4 weeks.
It may be a good idea to prepare your home for your return before having surgery. Here’s a detailed timeline of the rehabilitation and recovery process after a total knee replacement.
Some weeks before the procedure, your surgeon will take you through a preoperative evaluation, or pre-op.
They will ask you questions about:
- your overall health
- your medical history
- any medications and supplements you use
- any specific concerns you may have
They will also do the following:
Carry out tests to check that you are ready for the procedure and assess for possible complications. These may include kidney and lung tests.
Ask you to sign a consent form and provide details of emergency contacts.
Let you know of any preparations you should make before the day. For example, you may need to stop taking certain medications temporarily.
Cost can vary, depending on where you have the procedure and your overall health at that time.
If you have other conditions that are not related to your knees, they may affect the procedure and cost as well.
When considering the cost of the procedure, you should also consider additional costs for:
- your hospital stay
- physical therapy in the hospital
- therapy during your recovery at home
- follow-up appointments and care
- getting help at home
- transportation costs
You’ll also need to know how much your insurance will cover and how much you’ll need to pay from your own pocket.
Exercise plays a key role in preventing knee damage, supporting the knee during treatment, and recovery.
Exercise can help prevent joint damage by:
- strengthening the muscles around the knee
- helping you maintain a healthy weight
This is true both before and after surgery, whether for the natural or the artificial knee.
Chronic pain and mobility issues can increase the risk of social isolation. Joining an exercise class may be a good way to connect with other people, some of whom may have similar health issues.
Physical activity can also help you feel good and reduce the risk of anxiety and depression.
Guidelines from the American College of Rheumatology/Arthritis Foundation strongly recommend exercise for managing OA of the knee.
Activities that may prove useful include:
- strengthening exercises
- water exercise
- tai chi
Alongside exercise, weight is crucial for managing OA of the knee. Learn more about the link between weight and OA.
After a knee replacement, your physical therapist will most likely have an exercise protocol for you to follow.
This will include getting back on your feet as soon as possible after surgery and walking a little farther every day.
These exercises will help strengthen your knee and speed up your healing.
It is important to follow instructions carefully so that your recovery stays on track. It will help you return to your normal daily activities as quickly as possible.
It will also help you establish a routine that can support your health on an ongoing basis.
You will have pain for a while after your knee replacement, but your doctor will give you medication to help manage this.
It is important to let your doctor know how well your medication is working for you, and if you have any adverse effects.
All surgery can involve complications. After knee replacement surgery, there may be a risk of:
- blood clots
- continuing pain, even when surgery is successful
Most people don’t experience severe complications and are very happy that they had their knee replaced. The healthcare team will work with you to ensure the risks are as low as possible.
Replacement knees can wear out, at which point a second knee replacement may be needed. However, researchers say that over
Osteoarthritis is a very common reason that people have knee surgery but surgery may also be needed in people with:
- a knee injury such as a ligament tear or meniscus tear
- a knee deformity that they were born with
- rheumatoid arthritis
Most people with knee pain do not ever require surgery and can be treated non-operatively. Your doctor may suggest:
- losing weight
- getting more exercise or following a specific exercise plan
- using over-the-counter or other medications
Making the decision
The doctor may carry out some tests to see if you need surgery, and you will have a chance to ask questions. Find out what might happen in this appointment.
In most cases, a total knee replacement reduces pain and improves mobility. However, surgery can be costly, it can take several weeks or months to recover, and there is a small risk of complications.
For these reasons, you should learn as much as you can about the pros and cons of knee replacement surgery before going ahead.
In a partial knee replacement, the surgeon only replaces the part of your knee that is damaged.
Compared with a total knee replacement, this procedure has the following advantages:
- It needs a smaller incision.
- There is less loss of bone and blood.
- Recovery is usually faster and less painful.
However, if you have a partial knee replacement, you may need additional surgery in the future if arthritis develops in the parts of the knee that aren’t replaced.
In bilateral or double knee replacement surgery, the surgeon replaces both knees at the same time.
If you have OA in both knees, this can be a good option, as it means you only have to go through the procedure and recovery process once.
However, rehabilitation will probably take longer and you will likely need much more help during recovery.
Knee replacement surgery is a very commonly performed operation.
After surgery and recovery, many people are able to participate in activities they used to do, such as walking, bicycling, golf, tennis, and swimming.
While there is always an element of risk with any surgery, this procedure is considered safe, and most people experience a reduction in pain and greater mobility.
Before deciding to go ahead, however, discuss the benefits and risks with your healthcare provider, including the cost and the amount of time you may need off work.
For many, knee surgery can improve their ability to function from day to day and their quality of life.