If arthritis or injury has severely damaged your knee, you likely dread simple activities, such as walking or climbing stairs.
You struggle to escape the pain even while sitting or lying down. Not only that, but medications may leave you lacking energy. Walking supports, helpful earlier on, may have grown less effective.
Life doesn’t have to be that way, though
By resurfacing damaged and worn knee surfaces, total knee replacement surgery can relieve your pain, correct a leg deformity, and get you back to the activities you love. One of the most important orthopaedic surgical advances of this century, knee replacement was first performed in 1968. Improvements in surgical materials and techniques since then have greatly increased its effectiveness.
Dr. Puri uses high performance knee implants in his patients’ knee replacements. In the vast majority of instances, the implant is cemented in order to obtain immediate fixation and to enable patients to return to function.
Partial Knee Replacement
Approximately 10% of patients who qualify for knee replacement surgery are candidates for partial knee replacement surgery. This less invasive procedure enables the patients to return more quickly to function. They also have a slightly more normal appearing and functioning knee when compared to a full knee replacement.
Patients who have arthritis in one particular area of the knee without any arthritis in the other parts of the knee may be candidates for this type of procedure depending upon the severity of the disease.
You’ll be admitted to the hospital the day of your surgery, and a member of the anesthesia team will evaluate you. The most common type of anesthesia for knee replacement surgery is a spinal anesthesia with sedation (which allows you to be awake but anesthetizes your body from the waist down). In certain cases, it may be necessary to perform a general anesthetic, which puts you to sleep through the procedure. The anesthesia team will discuss these choices with you and help you decide which type of anesthesia is best for you.
After surgery, you’ll be moved to the recovery room where you will remain for one to two hours so that recovery from the anesthesia is also monitored. You’ll then be transferred to a private room.
Expect to sit up on a chair on the first night of your surgery. You’ll then start to walk using an assistive device (crutches or walker) on the following day. You’ll have achieved your therapy goals for safe discharge on days two or three.
Your Stay in the Hospital
You’ll stay in the hospital for 1-2 days. After surgery, you’ll feel pain in your knee, and pain medication will help make you as comfortable as possible.
Dr. Puri encourages what he calls a “Rapid Recovery Program.” Foot and ankle movement is encouraged immediately following the surgery to increase blood flow in your leg muscles, helping prevent leg swelling and blood clots. Most patients begin exercising their knee the day after surgery. A physical therapist will teach you specific exercises to strengthen your leg and restore knee movement, allowing walking and other normal daily activities soon after your surgery.
How Your New Knee is Different
You may feel numbness or stiffness in the skin around your incision, particularly with excessive bending activities. Improvement of the knee motion is a goal of total knee replacement but restoration of full motion is uncommon. Most patients can expect to nearly fully straighten the replacement knee, bend the knee sufficiently to go up and down the stairs, and get in and out of a car. Kneeling is typically uncomfortable, but it is not harmful.
Occasionally, you may feel some soft clicking of the metal and plastic with knee bending or walking. These differences often diminish with time, and most patients find these are minor, compared to the pain and limited function they experienced prior to surgery.
Please note that your new knee may activate metal detectors required for security in airports and some buildings. Tell the security agent about your knee replacement if the alarm is activated.
After your surgery, make sure you:
Participate in a regular light exercise program to maintain proper strength and mobility of your new knee
Take special precautions to avoid falls and injuries. In the event you sustain a fall, please go to the closest emergency room to get evaluated and rule out any fractures
Notify your dentist that you have had a knee replacement. You should be given antibiotics before all dental surgery for the rest of your life
See Dr. Puri periodically for routine follow-up examinations and x-rays