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Knee Questions: Knee Arthritis Total Knee Replacement Oxford Knee Replacement ACL Reconstruction Patello Femoral Pain Cartilage Injury Meniscus Injury back |
| _________________________________________________________________ What is a total knee replacement? A total knee replacement consists of three pieces. These are made of rugged polyethylene (high density plastic) and alloy metals. These pieces resurface the three bones that comprise the knee joint (the femur, tibia, and patella). The femoral component (the end of the thighbone) is made of alloy metal (cobalt chrome). The tibial component (the top of the shin bone) has a metal tray with a snap- in plastic insert with a groove in the femoral components. These components are usually held in place with cement. This cement is actually a polymer that serves as a grout and is not an adhesive. Occasionally we will press-fit the components. This relies on the ingrowth of the patient's own bone for fixation and is used based upon the patient's age and quality of bone. How long do they last? Design changes have occurrd in recent years and current prostheses have been improved in an effort to yield better function and longevity. Since the prostheses now being used are of newer designs we do not exactly know how long they will last. Most studies have found that at 10 years 90% of all knee replacements are functioning well. Another study has found that, at 18 years, 94% of knee replacements are still functioning. A well-implanted prosthesis, in a compliant patient, usually lasts for many years. Strenuous use and obesity have the potential to shorten the life of the implant. It should be emphasized that total knee replacements are not done to allow the patients to return to unlimited activities. Fitness may be maintained by "low impact" sports such as swimming or bicycling. Golfing and bowling are usually possible, and even moderate skiing in some individuals. Jogging is not recommended. Doubles tennis is preferred to singles. What is the hospital stay like? - You will be admitted the day of surgery and remain hospitalized for approximately 3 days. Immediately after your knee replacement you may place your full weight on your new knee. We will begin your therapy the day of your surgery and emphasize walking, regaining your range of motion and strengthening exercises. The quicker we can get you home, the better off you will be. - Transfusions are occasionally needed during or after surgery and we often encourage our patients to donate their own blood a few weeks before surgery. If you do require blood from the blood bank we reassure you that it is safe. There is less than a 1 in 1.7 million chance that you would receive a blood product with the HIV virus. - Your pain is controlled with injections and later by pain pills. Your discomfort should significantly decrease by the third day and only require pain pills before performing therapy. After all major orthopedic surgeries, the patient is at risk of developing a blood clot. Occasionally, a blood clot can break free from their location in the leg veins and travel via the blood stream to the lungs, causing serious complications and even death. We can significantly decrease this risk by placing you on a blood thinner for approximately 6 weeks. This will require regular blood checks to determine the proper dosage of the medication. What are potential complications? - The most common complications after a knee replacement are infection and blood clots. We can lower the risk of infection to less than 1% by using special operative suites, meticulous operative technique, and antibiotics before surgery and for 48 hours after surgery. If an infection does occur, another surgery may be required to "wash out" the infection from the knee. Occasionally the knee prostheses must be removed to allow eradication ofinfection. Usually a new prosthesis can be implanted after the infection is cleared. - We significantly lower the risk of blood clots by placing you on a blood thinner for approximately 6 weeks. If you develop significant leg swelling or shortness of breath, you need to seek immediate medical attention to evaluate for a blood clot or embolus. - Other complications include: dislocation of the components, premature loosening, fractures around the components, damage to nerves or arteries during surgery, and anesthesia risks. - We emphasize that these risks are rare and feel that the potential benefits from a knee replacement far outweigh the potential risks. We take significant precautions to lower these risks. What should I expect after surgery? - Discharge from the hospital can be expected on the third post-operative day. - The staples are usually removed from the skin in 10 to 14 days. - You may shower or immerse the knee in water two weeks from the time of surgery. - You may swim, use a Jacuzzi, or whirlpool in 2-3 weeks. - The operation of an automobile is not recommended until you are one-month post surgery so that the control of the extremity is regained. Patients who have surgery on the left knee can sometimes drive sooner. - Crutches or a walker are utilized for approximately 4-6 weeks. - Maximum recovery is attained in 3-6 months. You may notice that your knee may swell after activity for up to one year after surgery. |
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| Blair A. Rhode, M.D. ________________________________ Sports Medicine Knee/Shoulder/Elbow Reconstruction Specialist *Board Certified* |
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