Overview

Knee Replacement Symptoms

Knee Replacement Symptoms

You might want to consider a knee replacement (also called total knee arthroplasty or TKA) if:

  • Medication, physical therapy, and injections have failed to reduce pain in your knee, and/or
  • Knee pain limits your ability to walk, work, or perform simple activities.

Benefits of Knee Replacement Surgery

Knee replacement surgery offers a solution for patients that suffer from knee pain. In knee replacement surgery, we replace the damaged parts of the knee or the entire knee. This procedure aims to:

  • Make it less painful to move your knee,
  • Improve knee function, and
  • Improve your quality of life.

There are two different kinds of knee replacements: total knee replacement and partial knee replacement (uni-compartmental knee arthroplasty).

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Partial Knee Replacement Surgery

Before knee replacement
Before
Before knee replacement
After

Partial Knee Replacement Vs. Total Knee Replacement

The benefits of a partial knee replacement are the following:

  • Relieve pain in the replaced area
  • Extend the time before you might have to replace the whole knee
  • Keep a more natural-feeling knee, because you keep your ACL (a ligament needed for running and jumping)
  • Recover faster (one day in the hospital and faster rehabilitation at home)

There may be more benefit to a total knee replacement if these things are possible:

  • You may only have partial pain relief
  • Your knee joint will continue to wear in the other parts of the knee

Partial Knee Replacement Surgery

Typically, you will have surgery and go home the next day from the hospital. You will have a physical therapist to do exercises with, or they will teach you how to do them on your own.

Stiffness is not as big of a problem as it can be when we replace the whole knee. Infection, however, is always a concern whenever we put metal into someone's body. Also, as long as you are up and active, blood clots in the leg are very rare.

You will be seen two weeks from surgery for your staples to be removed, then again at six weeks from surgery to see the surgeon and check X-rays. You'll be allowed to drive at two to three weeks from surgery, return to work when you feel ready and stop using a cane when you can walk well without a limp. Full activities can be resumed at six weeks from surgery, as tolerated.

Total Knee Replacement Surgery

Before knee replacement
Before
Before knee replacement
After

What Does Knee Replacement Surgery Involve?

The surgery, called total knee arthroplasty (TKA), involves the removal of small slices of bone from the ends of the bone. Then the bone is capped with metal parts. Finally a polyethylene (plastic) liner is locked in between the metal components.

Hospital Stay

For an uncomplicated total knee surgery, you will stay at the hospital about one to three days after surgery.

Physical Therapy

Starting the afternoon after surgery you will have physical therapy. Each day after you will have physical therapy twice a day. This includes exercises—learning to sit, stand, and walk—with your new total joint.

Patients usually take a few steps the first day, then walking around your room and so on. After you leave the hospital, you will have a list of the exercises you have learned to continue yourself at home. Many patients will receive physical therapy at home.

Total Knee Replacement Surgery Recovery

When you leave the hospital, you will usually need 24-hour help for a week. If you don't have adequate help at home, you should consider a rehab facility or extended care facility. You can check with your insurance to see who is approved, but the final plans will be made with our case management team while you are in the hospital.

Recovery involves the following:

First Four to Six Weeks

  • Do your physical therapy exercises
  • Keep the wound clean: no ointments or lotion on the wound
  • wear your TED hose for those four weeks
  • Take blood thinners (Coumadin managed by the anti-coagulation service)
  • Walk as you are able with crutches/walker
  • Transition to a single crutch/cane as when you are able

Your staples will be removed two weeks after surgery.

Next Six Weeks

  • Continue exercises, walk, use a stationary bicycle
  • Use a crutch/cane until walking without a limp
  • Return to work part time or full time as you are able (as early as four to six weeks from surgery)
  • Return to full activity when you are ready except for running/jumping activities; kneeling on a TKA may be difficult but won’t damage it.

We will see you six weeks after surgery, six months, one year, and two years for the rest of your life. We take X-rays at six weeks and yearly (even if you live out of town we like to see copies).

The best lifelong activities at this point are walking, swimming, and biking.

How Long Does It Take Pain to Go Away After Knee Replacement?

Generally you will only take narcotics for pain as long as you need them, usually about 5–14 days from the day of surgery. After that Tylenol will usually handle the pain.

When Can I Drive After Knee Replacement Surgery?

Usually three to four weeks after surgery. Make sure you have control of your leg, no spasms, off pain medication, and use caution.

Risks of Knee Replacement Surgery

The major risks include the following:

  • Blood clot: We reduce risk of this by using blood thinners (Enoxaparin, Aspirin, or Coumadin), TED hose (compressive stockings) and compression boots on your feet to increase circulation.
  • Infection: You are given IV antibiotics before and after surgery.
  • Nerve, blood vessel damage: We work close to important vessels and nerves, and take extreme care to not to injure these structures.
  • TKA dislocation: You can avoid this by following total hip precautions.
  • Medical complications: Can occur with existing or new medical problems

What If I Get an Infection?

Infection if very rare, but a difficult complication. Read more about joint infection after replacement.

Knee Replacement Complications

If you experience problems with your wound or joint replacement, please call the clinic immediately or the University of Utah Hospital operator to have the orthopedic resident on call paged:
801-581-2121

If it is after 5 pm, go to your nearest emergency department.

How Long Does a Total Knee Replacement Last?

Today, total joint replacements last 15–20 years depending on the amount of activity you do and your general health. You may need another surgery depending on how old you are and how much wear and tear you put on your total joint.

Do Total Joints Wear Out?

The metal parts of total joints can loosen over time, but often the cause of wear is from the bearing surface. Your immune system attacks the particles from the bearing surface but also melts bone away. Now we are using a metal liner (metal-on-metal), ceramic-on-ceramic and cross-linked polyethylene liners that wear less than what we had years ago.

Lifestyle Habits After Joint Replacement

After a joint replacement, patients can resume just about everything, especially walking, swimming, and bicycle riding. We discourage repetitive jumping and running, yoga, or excessive stretching.

You should also take prophylactic antibiotics, because total joints are made of metal and are at risk for infection when bacteria circulate through your bloodstream.

If your joint becomes infected, it requires more than two additional surgeries. Therefore, take antibiotics with any bacterial infection as prescribed by your family practitioner. We strongly recommend that you take antibiotics for all dental and invasive procedures for the rest of your life.

Peripheral Nerve Blocks

For total or partial knee replacements, the anesthesiologist will offer you a peripheral nerve block. Learn more about the use of peripheral nerve blocks.