Total Knee Replacement

Total knee replacement implants normally make a slight snap or popping sound with certain activities or maneuvers. Typically this is painless and does not present any problem.

You should expect a significant reduction in pain and an improvement in functionality for daily living activities.  Everyone’s situation is unique and therefore results very.  The knee replacement is made of artificial parts and cannot be expected to function and feel like the normal knee you had when you were 16! 

Yes.  We have prepared a two-page document with instructions for your specific care after a total knee replacement.  

These instructions cover very important subjects such as:

• WOUND CARE
• ACTIVITY
• MEDICATIONS
• RETURNING TO WORK
• SURGERY FOLLOW-UP
• YOUR DIET WHILE YOU HEAL
• WHEN TO CALL YOUR DOCTOR. 

Click here to download these specific instructions.

It is important to follow up with your surgeon after your joint replacement. In most cases, joint replacements last for many years.

The frequency of required follow up visits is dependent on many factors including the age of the patient, the demand levels placed on the joint, and the type of replacement. We will consider all these factors and tailor a follow-up schedule to meet your needs. 

In general, seeing your surgeon every three to five years is recommended.

The American Academy of Orthopedic Surgery (AAOS) and American Dental Association (ADA) have generally recommended short-term antibiotics prior to dental procedures (one dose one hour prior to dental procedure) for patients who have had joint replacements. This recommendation continues for up to two years after your joint replacement. 

Two or more years after the replacement, continued use of antibiotics prior to dental procedures is based on the discretion of the treating surgeon and the patient. Your surgeon will consider many factors including whether or not you are at increased risk of infection due to immune suppression (i.e. diabetic, transplant patients, and rheumatoid arthritis). 

The use of prophylactic antibiotics prior to dental cleanings and other invasive procedures remains controversial. Most orthopaedic surgeons now recommend lifetime prophylaxis. Patients should discuss whether or not they need antibiotics prior to dental or other invasive procedures with their treating orthopedic surgeon.

Usually patients with joint replacements will set off metal detectors. This should not be of great concern. It is reasonable for you to inform the TSA screening agent at the airport that you have had a joint replacement; however, you will still require screening and will need to follow the directions of the screening agent. There are millions of individuals with joint replacements, and screening protocols recognize that people who have had joint replacements may set off detectors. Joint replacement documentation is not required.

Click Here To Watch A Video and Learn More About Metal Detectors and Your New New Joint!

Very few. We advise against any extremes – no extreme positions or activities.  No yoga or marathon running, etc.

Returning to work is highly dependent on your general health, activity level and the physical demands of your job. If you have a sedentary job, such as computer work, you can expect to return to work in two to three weeks. If you have a more demanding job that requires lifting, walking, or travel, you may need up to three months for full recovery.

Depending on which leg… the right knee would obviously take a little longer to properly use the brake and gas pedals. All patients have to be off narcotics and no longer depending on a walker before they are able to drive on their own. Most patients are driving at four to six weeks after surgery, and sometimes sooner if the operative leg is the left leg.

The same day! Most people are walking with the assistance of a walker on the day of surgery with the physical therapist.   Prompt walking has been shown to reduce the risk of post-operative blood clots and is an important part of your recovery. Within the first month or two after surgery, you may walk using a cane or no walking aids depending on your progress. Despite the rapid progression to moving without assistance, it is typically not recommended that you return to aggressive/sporting activities until the third month after surgery.

We used advanced water proof bandages so you typically can take a shower within 48-72 hours depending.

Yes.  In contrast to hip replacement surgery, almost all knee replacement patients require formal physical therapy in order to maximize the results of the knee replacement surgery.  Ideally, this is performed at an outpatient physical therapy facility close to your home following your discharge from the hospital.  Typically this is 3 sessions a week for approximately 6-8 weeks.

The majority of people who undergo total knee replacement are able to participate in a majority of their daily activities by six weeks. By three months, most people have regained much the endurance and strength lost around the time of surgery, and can participate in daily activities without restriction. While daily activities have resumed, it is important to avoid high impact activities to give you the best long-term outcome with your knee.

You can expect the majority of your recovery to occur within the first 6-12 weeks following knee replacement surgery however you can also expect the new knee to continue to slowly improve with respect to warmth, swelling, strength, and function for up to a year following the knee replacement procedure.

It varies. Some patients will go home the same day while others may need to stay a couple of days. This is highly dependent upon your condition before surgery, your age, and medical problems which can influence your recovery. A safe discharge plan will be arranged for you by our orthopaedic team.

Typically, a spinal block is used and is a very safe option. There are other options available as well depending on what is best for each patient.

Typically, regaining the ability to kneel can be expected following knee replacement surgery. Nevertheless, this is dependent upon the patient’s ability to kneel prior to surgery and the level of obesity, strength and general well-being.  Specifically once completely healed the replaced knee is capable of being kneeled upon.

Bowed leg and knocked knee deformity are common in severe arthritis of the knee.  Correcting the deformity at the time of surgery is typical and a routine part of knee replacement surgery.  Severe angular deformities can make the surgical procedure more complex.  Occasionally the routine physical therapy protocol is modified as a result of the more complex procedure.  Additionally once the angular deformity is corrected the patient may perceive the corrected knee has produced a longer leg.  This perceived leg length inequality typically improves over time or in certain situations is corrected once the opposite knee is corrected.

Typically, the incision will be about 6 to 8 inches long but depending on the surgical needs – it is what is done underneath the skin that counts not the length of the incision! Your surgeon will make the incision as large as it needs to be in order to perform an excellent surgery.

You may have relatively mild to moderate pain following the procedure, or you may have a more difficult time than others. Everyone is unique and handles and perceives pain differently. Keep in mind that while pain management has greatly improved, a pain-free surgery is unlikely. You will want to take your pain medicines as directed by your surgeon.  The instructions on the pill bottle describe the maximum dose and frequency of the prescribed pain medicine.  It is preferable to reduce the amount of narcotic pills as much as possible and minimize the amount of narcotic/opioids taken.

Knee replacements do wear and can eventually wear out. Unfortunately, an artificial knee is not as durable as your own natural knee. Because the knee replacement implants are made of metal and plastic, these materials do wear over time, similar to the treads on your car tires.

Studies show that knee replacements can last more than 20 years. This is dependent on many factors.  The activity level, weight and age of the patient can effect the longevity of the joint. One very large study found that 80% of knee replacements were functioning well after 15 years in the younger (less than 65) patients, and 94% of the older (over 65) patients.

Typically, patients who undergo Total Knee Arthroplasty may require a 1-2 night hospital stay but some patients can go home the same day as their surgery. Each patient recovers differently but all must reach the following goals before being discharged home:

• Vital signs stable (Blood pressure, heart rate, Temperature, Respirations)
• Ability to get from the bed to the bathroom and back to the bed with or without a walker.
• Ability to walk 50 feet down the hall and back.
• Ability to urinate.
• Nausea and/or vomiting controlled.
• No medication interactions or adverse side effects.
• Ability to tolerate eating and drinking.
• Pain reasonably controlled with Oral Medications.
• Diabetic patients must have their blood sugars well controlled.

Potential risks of knee replacement surgery include but are not limited to: Blood Clots, Blood Loss, Infection of the Joint Replacement, Leg Length Difference, Knee Implant Loosening, Fracture of the patient bone, Numbness around the incision site, nerve disfunction resulting in numbness and loss of control of the foot and/or ankle, Wound healing delay and/or wound separation.

Your surgeon and the entire surgical team have worked diligently to put together a program that significantly reduces the risk of complications. Over the last few years the complication rates have definitely been reduced but the potential for complications still exist and have not been completely eliminated.

Depending on your Body Mass Index (BMI), you may be told that you need to reduce your weight prior to surgery.  People with a BMI score of over 35 can have a much more difficult time healing and have an increased risk of complications.

Here are some of the specific complications associated with obesity after joint replacement surgery:

• Infection
• Poor wound healing
• Difficulty breathing
• Blood clots
• Blood loss
• Pulmonary embolism (a blood clot in the lungs)
• Difficulty participating and meeting the required goals of the physical therapy program
• Falls resulting in catastrophic injury to the new and healing knee replacement.

CLICK HERE TO FIND OUT WHAT YOUR BMI SCORE IS AND MORE INFORMATION ON THE SUBJECT.