Knee replacement- All that you should know about Knee Replacement Surgery

Knee replacement, commonly known as knee arthroplasty or total knee replacement, is a complex surgical procedure to resurface a knee damaged caused due to arthritis. Inmost of the cases a Metal and plastic parts are used for the procedure that caps the ends of the bones that form the knee joint, along with the kneecap. This surgery may be considered for someone who has severe arthritis or a severe knee injury. Below are a few things that you should know when you plan for a knee replacement surgeries

Stages of Knee Osteoarthritis (OA)
Stage 0: Normal: It indicates “normal” knee health where the knee joint shows absolutely no signs of OA and the joint functions without any impairment or pain.

Stage 1:Minor: The presence of a few Bone spurs which are bony growths that develop where bones meet each other in the joint. This can be presented with minor loss of cartilage but not enough to compromise the joint space.

Stage 2: Mild: X-rays of knee joints in this stage will show greater bone spur growth, however, the cartilage usually still remains at a healthy size. The space between two bones is normal, and the bones aren’t rubbing or scraping against one another.

Stage 3: Moderate: The cartilage between bones shows damage, and the space between the bones begins to narrow. Patients experience frequent pain when walking, running, bending, or kneeling.

Stage 4: Severe: Patients experience great pain and discomfort when they walk or move the joint owing to the dramatic reduction in the space between the bones

Benefits of Knee replacement surgery:

Day 1- Within the first 24 hours, your Physiotherapist (PT) will help you to stand up and walk with the help of an assistive device which can be walkers, crutches, and canes.

Day 2- On the second day, you will be made to walk for brief periods using an assistive device. As you recover from the surgery, your activity level will be increased gradually.

Discharge day: By now your knee should be getting stronger and you’ll be able to stand with minimal or no help, go on longer walks outside your hospital room, get dressed, shower, and use the toilet on your own, maybe climb up and down a flight of stairs with help

Week 3: Your pain levels would have reduced and you should be able to move around more freely. You’ll require a mild dose of pain medications.

Week 4-6: If you’ve religiously followed your rehab schedule and exercise chart as suggested by your physiotherapist, you will notice a dramatic improvement in your knee, including bending and strength. The swelling, pain and inflammation should also have gone down.

Week 7-11: Your physiotherapy and exercise regimen will continue up to 12 weeks. You will focus more on improving your mobility and range of motion and at the same time increasing strength in your knee and the surrounding muscles.

Week 12: At this point, you should have much less pain. However, you should avoid high-impact activities or high-intensity workouts that could damage your knee including the surrounding tissues. A few examples of such activities are running, aerobics, skiing, basketball, football, high-intensity cycling

Week 13 and beyond: Your knee will keep on improving and gradually over a period of time pain will reduce too. There’s a 90 to 95 percent chance that your knee will last for a minimum period of 10 years, and an 80 to 85 percent chance it will last 20 years.

Why You Should Not Delay Surgery?

Patients often delay knee replacement surgery because of two significant reasons, firstly due to fear and secondly due to the apprehensions about the recovery process. While many people worry about the after-effects of the surgery, few put it on hold, thinking about what probably may happen if they wait. Below are a few consequences of the same

  • Increased knee pain
  • Compromised mobility and ability to use the knee
  • Knee deformity, therefore harder to replace
  • Further degenerative changes to the joint
  • Kneecap resurfacing may be required
  • Unnecessarily complications. For instance, in early intervention, a patient may only need a “partial”
    knee replacement, but prolonged waiting may lead to “total” knee replacement — which is a more complex procedure.

FAQ’s about Knee replacement surgery

When do I have to get admitted to the hospital and what happens after that?
You would be admitted to the hospital on the evening before the day of the operation. Certain tests and examinations will be done to ensure that all the parameters are well in control to undergo the operation.

What kind of anaesthesia would be used for the operation?
Knee replacement surgery is usually performed under Spinal Anesthesia and Epidural Analgesia. It works by numbing your legs so that you do not feel the operation. You will also be administered medications that will help you relax and fall asleep, but you will still be able breath on your own

How long does the surgery last?
The procedure of Knee replacement usually requires 45 minutes to 1 hour. However, preoperative preparation and certain procedures after surgery will make your stay in the operation room for about two-to two-and-half-hour.

Would I require a blood transfusion during or after the operation?
Robotic Knee replacement reduces the blood loss by precise incision and minimal tissue damage. In addition to this with use of a tourniquet, blood loss during surgery is further reduced. So during surgery, usually blood transfusion is not needed.

Will I need to go for physiotherapy and how painful is that?
Physiotherapy is the most integral and unavoidable part of knee replacement surgery. Nothing like “No Physio Knee Replacement” exists. A mild to moderate level of discomfort will be there during the initial stages of your rehabilitation. However, if you diligently follow the post-operative rehabilitation regimen and your exercise schedule you will reap long term benefits.

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