The procedure involves cutting away damaged bone and
cartilage from your thighbone, shinbone and kneecap and replacing it with an
artificial joint (prosthesis) made of metal alloys, high-grade plastics and
In determining whether a knee replacement is right for you,
an orthopedic surgeon assesses your knee's range of motion, stability and
strength. X-rays help determine the extent of damage.
Your doctor can choose from a variety of knee replacement
prostheses and surgical techniques, considering your age, weight, activity
level, knee size and shape, and overall health .
Why it's done
The most common reason for knee replacement surgery is to
relieve severe pain caused by osteoarthritis. People who need knee replacement
surgery usually have problems walking, climbing stairs, and getting in and out
of chairs. Some also have knee pain at rest.
Knee replacement surgery, like any surgery, carries risks.
* Blood clots in the leg vein or lungs
* Heart attack
* Nerve damage
Signs of infection
* Notify your doctor immediately if you notice:
* Fever greater than 100 F (37.8 C)
* Shaking chills
* Drainage from the surgical site
* Increasing redness, tenderness, swelling and pain in the
An infected knee replacement usually requires surgery to
remove the artificial parts and antibiotics to kill the bacteria. After the
infection is cleared, another surgery is performed to install a new knee.
Artificial knees can wear out
Another risk of knee replacement surgery is failure of the
artificial joint. Daily use wears on even the strongest metal and plastic
parts. Joint failure risk is higher if you stress the joint with high-impact
activities or excessive weight.
How you prepare
Food and medications
Your doctor or anesthesiologist might advise you to stop
taking certain medications and dietary supplements before your surgery. You'll
likely be instructed not to eat anything after midnight the day of your
Prepare for your recovery
For several weeks after the procedure, you might need to use
crutches or a walker, so arrange for them before your surgery. Make sure you
have a ride home from the hospital and help with everyday tasks, such as
cooking, bathing and doing laundry. If you live alone, your surgeon's staff or
hospital discharge planner can suggest a temporary caretaker.
To make your home safer and easier to navigate during
recovery, consider doing the following:
* Create a living space on one floor since
climbing stairs can be difficult
* Install safety bars or a secure handrail in
your shower or bath
* Secure stairway handrails
* Get a stable chair with a firm seat cushion
and back, and a footstool to elevate your leg
* Arrange for a toilet-seat riser with arms if
you have a low toilet
* Get a stable bench or chair for your shower.
* Remove loose rugs and cords.
What you can expect
Knee replacement surgery requires anesthesia. Your input and
preference help the team decide whether to use general anesthesia, which makes
you unconscious, or spinal anesthesia, which leaves you awake but unable to
feel pain from your waist down.
You'll be given an intravenous antibiotic before, during and
after the procedure to help prevent post-surgical infection. You might also be
given a nerve block around your knee to numb it. The numbness wears off
gradually after the procedure.
During the procedure
Your knee will be in a bent position to expose all surfaces
of the joint. After making an incision about 6 to 10 inches (15 to 25 centimeters)
long, your surgeon moves aside your kneecap and cuts away the damaged joint
After preparing the joint surfaces, the surgeon attaches the
pieces of the artificial joint. Before closing the incision, he or she bends
and rotates your knee, testing it to ensure proper function. The surgery lasts
about two hours.
After the procedure
You'll be taken to a recovery room for one to two hours.
You'll then be moved to your hospital room, where you'll likely stay for a
couple of days. Medications prescribed by your doctor should help control pain.
During the hospital stay, you'll be encouraged to move your
foot and ankle, which increases blood flow to your leg muscles and helps
prevent swelling and blood clots. You'll likely receive blood thinners and wear
support hose or compression boots to further protect against swelling and
You'll be asked to do frequent breathing exercises and
gradually increase your activity level.
The day after surgery, a physical therapist will show you
how to exercise your new knee. After you leave the hospital, you'll continue
physical therapy at home or at a center.
Do your exercises regularly, as instructed. For the best
recovery, follow all of your care team's instructions concerning wound care,
diet and exercise.
For most people, knee replacement provides pain relief,
improved mobility and a better quality of life. And most knee replacements can
be expected to last more than 15 years.
Three to six weeks after surgery, you generally can resume
most daily activities, such as shopping and light housekeeping. Driving is also
possible at around three weeks if you can bend your knee far enough to sit in a
car, if you have enough muscle control to operate the brakes and accelerator,
and if you're not still taking narcotic pain medications.
After recovery, you can engage in various low-impact
activities, such as walking, swimming, golfing or biking. But you should avoid
higher impact activities — such as jogging, skiing, tennis and sports that
involve contact or jumping. Talk to your doctor about your limitations.