Knee replacement

You may be a good candidate for knee replacement surgery if you have osteoarthritis, which is the most common condition requiring knee replacement surgery. A degenerative joint disease that affects mostly middle-aged and older adults, certain forms of arthritis, such as rheumatoid arthritis and injury-induced arthritis, can also lead to severe joint degeneration requiring knee replacement surgery.

However, your orthopedic surgeon may suggest alternative treatments, such as using assistive walking devices and taking anti-inflammatory medicines before moving forward with surgery. Your surgeon will go over all the factors necessary to help you decide whether knee replacement is best.

Generally, total knee replacement surgery lasts up to two hours and usually involves these steps:

• The ends of the damaged thigh, shin and kneecap are capped with artificial surfaces lined with metal and plastic.
• An orthopedic surgeon replaces the entire surface at the ends of the thigh and shin bones.
• The surgeon secures knee joint components to the bone using special surgical cement.

Depending on the location of the damage, the surgeon may only need to perform a partial replacement to replace just the inner or outer knee surfaces.

General anesthesia is often used for joint replacement surgeries, meaning you will be unconscious during the procedure. However, sometimes regional anesthesia is administered, meaning you are awake but cannot feel the area being operated on. The choice of anesthesia depends on:

• The surgeon's and anesthesiologist's recommendations
• Your overall health
• Your preference

When you wake up from surgery, you will see a bandage on your knee and a drain to collect fluid from around the joint. You will also see a compression pump, which squeezes the legs to circulate blood.

Your surgeon may recommend spending time in a continuous passive motion machine (CPM) to help keep the new knee flexible. The CPM has a cradle for the operative leg.

While still in bed, your orthopedic team will teach you to do simple breathing exercises. These help prevent lung congestion. You will also learn how to do ankle pumps to flex the muscles and keep blood circulating.

How long will I stay in the hospital?

Knee replacement surgeries usually require an in-hospital stay of several days. You may take pain medication and anticoagulants, which help prevent blood clots.

During the hospital stay, your case manager will assess your discharge goals and help you set up any equipment you will use at home. Your case manager can also arrange home health agency services and inpatient rehabilitation.

Will I need physical therapy?

It is recommended to complete physical therapy and rehabilitation after a knee replacement, both in the hospital and when you return home. The goal of physical therapy is to be able to bend your knee at least to 90 degrees, which is enough to complete daily activities.