There’s no precise formula for determining when you should have a knee replacement. But if you’re having trouble getting up to answer the phone or walk to your car, you may be a candidate. A thorough examination by an orthopedic surgeon should yield a recommendation. It might also be beneficial to receive a second opinion.
For some, lifestyle modifications, physical therapy, medication, or alternative treatment methods such as acupuncture and prolotherapy (which involves injecting fluid to strengthen connective tissue) can help manage knee problems. Also, you may want to speak to your surgeon about other procedures that are commonly recommended before resorting to knee replacement surgery, including steroid or hyaluronic acid injections and arthroscopic surgery that addresses the damaged cartilage. However, delaying or declining a necessary knee replacement could result in a less favorable outcome. Ask yourself: Have I tried everything? Is my knee holding me back from doing the things I enjoy?
The surgeon will make an incision on the top of your knee in order to expose the damaged area of your joint. The standard incision size can be as long as 10 inches, but a minimally invasive procedure can result in incisions as short as 4 inches.
During the operation, the surgeon moves your kneecap aside and cuts away damaged bone and cartilage, which are then replaced with new metal and plastic components. The components combine to form a synthetic (but biologically compatible) joint that mimics the movement of your natural knee. Most knee replacement procedures take 1.5 to 2 hours to complete.
Implants are comprised of metal and medical-grade plastic. To seal these components to your bone, two methods are used: application of bone cement, which typically takes about 15 minutes to set, and a cement-less approach that uses components with a porous coating that grows into tissue or attaches to bone. In some cases, a surgeon may use both techniques in the same surgery.
Any surgery with anesthesia has risks. However, complication rates and mortality for general anesthesia are extremely low. An anesthesia team will determine whether general anesthesia or spinal, epidural, or regional nerve block anesthesia is best.
Although you’ll experience some pain after surgery, it should diminish quickly — within four or five days max. You may receive a nerve block the day of surgery, or your surgeon may use a long-acting anesthetic during your surgery to help with pain relief postoperatively.
Your doctor will prescribe medication to help you manage the pain, which may be administered intravenously (IV) immediately after surgery or taken orally. After you’re released from the hospital, you’ll switch to painkillers taken in a pill or tablet form.
After you’ve recovered from surgery, you should experience significantly less pain in your knee, but there’s no way to predict exact results — some will have knee pain for a full year after the surgery.
Your willingness to engage in physical therapy and make lifestyle modifications can have a significant impact on your postsurgery level of pain and adjustment to the implant.
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