If a doctor has told you that you need a knee replacement, you probably have a lot of questions about what to expect. This article tells you everything you need to know before surgery.
There’s no precise formula for deciding when to have a knee replacement. The main reason to have it done is pain. If you’ve tried other options, including lifestyle strategies, anti-inflammatory medication, physical therapy, and injections, it may be time to think about surgery.
An orthopedic surgeon will perform a thorough examination and make a recommendation. You might also want to get a second opinion.
5 reasons to consider knee replacement surgery
Before you consider surgery, your doctor will usually encourage you to try various nonsurgical treatments, which may include:
- physical therapy
- weight loss (if appropriate)
- anti-inflammatory medication
- steroid injections
- hyaluronic (gel) injections
- alternative treatments such as acupuncture
In some cases, these solutions
Ask yourself questions such as:
- Have I tried everything?
- Is my knee preventing me from doing the things I enjoy?
- Will a knee replacement improve my quality of life?
Get more information to help you determine whether you should consider knee surgery.
The surgeon makes an incision over the front of your knee to expose the damaged area of your joint. They move your kneecap to the side and cut away the damaged cartilage and a small amount of bone.
Then, they replace the damaged tissue with new metal and plastic components. The components combine to form an artificial joint that is biologically compatible and mimics the movement of your natural knee.
Most knee replacement procedures take 1 to 2 hours to complete.
Learn more about what happens during knee replacement surgery.
Artificial knee implants consist of metal and medical-grade plastic called polyethylene.
There are two ways of attaching the components to the bone. One is to use bone cement, which usually takes about 10 minutes to set. The other is a cement-free approach, which involves components that have a porous coating to allow the bone to grow onto them.
In some cases, a surgeon may use both techniques during the same operation.
Any operation that involves anesthesia has risks, but severe complications are rare.
If you’re having a total knee replacement, your options are:
- general anesthesia
- spinal or epidural anesthesia
- a regional nerve block
An anesthesia team will decide on the most suitable options for you, but most knee replacement procedures involve a combination of the above methods.
You’ll definitely experience some pain after your operation, but your surgical team will do everything possible to keep it manageable and minimal.
You might receive a nerve block before your operation, and your surgeon might use a long-acting local anesthetic during the procedure to help with pain relief after the procedure. Your doctor will also prescribe pain medication.
Once you recover from surgery, your knee should be significantly less painful than it was before. However, there is no way to predict the exact results, and some people continue to have knee pain for many months after the operation.
Find out more about the medications you may need after surgery.
If you received a general anesthetic, you might wake up feeling a bit confused and drowsy. You’ll probably wake up with your knee raised (elevated) to help with swelling.
To reduce your risk of developing a blood clot, you may need anticoagulant medication (blood thinners), foot/calf pumps, or both.
Many people have an upset stomach after surgery. This isn’t anything to worry about, and your healthcare team may provide medication to ease the discomfort.
Your doctor will also prescribe intravenous (IV) antibiotics to reduce your risk of infection. Antibiotics can help prevent infections, but it’s important to be able to recognize the signs of an infection in case one occurs after knee surgery.
Most people are up and walking within 24 hours with the help of a walker or crutches.
After your operation, a physical therapist will help you bend and straighten your knee, get out of bed, and ultimately learn to walk with your new knee. This often happens on the same day as your operation.
Most people are discharged from the hospital the same day or the morning after surgery.
Once you return home, you’ll continue to have therapy regularly for several weeks. You’ll perform specific exercises that aim to improve the functionality of the knee.
If your condition requires it, or if you don’t have the support you need at home, your doctor might recommend that you spend time at a rehabilitation or nursing facility first.
Most people recover within 3 months, although it may take 6 months or longer for some people to recover fully.
If you live in a multiple-story house, prepare a bed and space on the first floor so you can avoid the stairs when you first come home, if possible.
Make sure your home is free of obstructions and hazards, including power cords, area rugs, clutter, and unnecessary furniture. Focus on pathways, hallways, and other places you are likely to walk through.
Make sure that:
- handrails are secure
- a grab bar is installed in the tub or shower
- a bath or shower seat is available
Most people need an assistive device (a walker, crutches, or a cane) for about 3 weeks after knee replacement surgery, although this varies significantly from person to person.
You’ll be able to do low impact exercise such as riding a stationary bike, walking, and swimming after 6–8 weeks. It’s important to make sure your incision has fully healed before swimming.
Your physical therapist can advise you on introducing new activities during this time. You should avoid running, jumping, and other high impact activities after surgery.
You can contact your orthopedic surgeon with any questions you have about your activities.
Learn more about setting realistic expectations after surgery.
According to a 2019 research review, more than
Younger people are more likely to need another knee surgery at some point in their lifetime, mainly as a result of having a more active lifestyle. You can consult a doctor about your specific situation.