Knee replacement surgery, also known as total knee arthroplasty, can relieve pain and improve mobility and quality of life in those with severely diseased or damaged knee joints. Knee replacement surgeries are the most common type of joint replacement surgery performed in the United States today, with about 200,000 such surgeries performed every year in this country.
Knee replacement surgery is most often performed due to severe and disabling knee pain caused by osteoarthritis, rheumatoid arthritis and other degenerative conditions. If you have tried traditional therapies such as resting, weight loss, pain medication, and physical therapy without success, or your knee pain significantly impacts your daily life and activities, you may be a candidate for knee replacement surgery.
When considering whether or not to undergo the surgery, it is important to have realistic expectations. Although 90 percent of patients who undergo the procedure experience a dramatic reduction of knee pain and are better able to go about daily activities and performs mild or moderately strenuous physical activities such as golf or swimming, more strenuous activities, such as jogging, are not recommended. Most patients are able to walk with the aid of a cane, walker, or crutches on the same day as the surgery and can expect the recovery period post-surgery to last about six to twelve weeks.
Knee replacement surgery has a 90 to 95% success rate and is considered one of the safest surgeries of its kind. However, excessive activity can cause the knee replacement to wear down or loosen and require replacement. 90 to 95% of knee implants are still functioning well 10 to 15 years after surgery, and with mild to moderate activity levels, most knee implants can be expected to function well for 15 years or more, but more strenuous activity can require more frequent replacement.
Surgery to replace the initial implants, called revision knee replacement, is generally not as successful as the first knee replacement, and the recovery can be more difficult. Other possible complications include infection, stiffness, loosening of the artificial joint, and osteolysis (continued breakdown of the bone around the artificial joint). The most serious potential complication is deep venous thrombosis, or DVT.
DVTs occur when a blood clot forms in the veins. If the clot becomes dislodged, it can travel to the lungs, where it can cause a potentially fatal pulmonary embolism. DVT is a risk following any major surgery and doctors and surgeons take its prevention very seriously. If you experience any of the following symptoms following surgery, notify your doctor immediately: increasing pain in the calf, tenderness or redness above or below the knee, increasing swelling in the calf, ankle, or foot, sudden shortness of breath, sudden onset of chest pain, or localized chest pain with coughing.
In recent years, the technology of knee implants has improved greatly. Most knee implants today are made of titanium- or cobalt/chromium-based alloys and ultra high-density polyethylene, which are sturdier and hold up better to wear and tear than materials used in the past, requiring less frequent replacement.
The design of artificial knee joints has also improved. The original knee replacement implants were often simple hinge joints, adequate for the purpose, but not wonderful. Lately, manufacturers of knee implants have been able to more successfully mimic the “roll-and-glide” movement of the knee and allow more complicated motions and movements. Patients who have undergone knee replacement surgery can now expect a more comfortable, normal life following surgery than ever before.