Training the Knee: Knee Replacement

What is a knee replacement?

Joint replacements are typically chosen as the best path to addressing long battles with arthritis and/or injury after non-surgical strategies have been exhausted. There are two types of knee replacements, full compartmental (total) and uni-compartmental (partial). The replacement device is usually made of titanium and these technologies are advancing every year. The knee replacement process is complex and unique to each patient. However, there are some simple things we can cover to make you feel more comfortable.

How common is knee replacement surgery?

Note: This is the most recent and trustworthy data I could find (for free) regarding knee replacements. In 2010, more than 4.5 million people were living with a full compartmental knee replacement. In 2010 alone, over 650,000 knee replacement surgeries were performed.

How do patients prepare for surgery?

via the American Academy of Orthopaedic Surgeons

Medical Evaluation

If you decide to have total knee replacement surgery, your orthopaedic surgeon may ask you to schedule a complete physical examination with your family physician several weeks before the operation. This is needed to make sure you are healthy enough to have the surgery and complete the recovery process. Many patients with chronic medical conditions, like heart disease, may also be evaluated by a specialist, such as a cardiologist, before the surgery.

Tests

Several tests, such as blood and urine samples, and an electrocardiogram, may be needed to help your orthopaedic surgeon plan your surgery.

Medications

Tell your orthopaedic surgeon about the medications you are taking. He or she will tell you which medications you should stop taking and which you should continue to take before surgery.

Dental Evaluation

Although the incidence of infection after knee replacement is very low, an infection can occur if bacteria enter your bloodstream. To reduce the risk of infection, major dental procedures (such as tooth extractions and periodontal work) should be completed before your total knee replacement surgery.

Urinary Evaluations

People with a history of recent or frequent urinary infections should have a urological evaluation before surgery. Older men with prostate disease should consider completing required treatment before undertaking knee replacement surgery.

Social Planning

Although you will be able to walk on crutches or a walker soon after surgery, you will need help for several weeks with such tasks as cooking, shopping, bathing, and doing laundry.

If you live alone, your orthopaedic surgeon’s office, a social worker, or a discharge planner at the hospital can help you make advance arrangements to have someone assist you at home. They also can help you arrange for a short stay in an extended care facility during your recovery, if this option works best for you.

Home Planning

Several modifications can make your home easier to navigate during your recovery.

How are patients treated after surgery?

There are potential complications and surgical revisions that arise after a knee replacement, but these are extremely rare.

via the American Academy of Orthopaedic Surgeons

Blood Clot Prevention

Follow your orthopaedic surgeon’s instructions carefully to reduce the risk of blood clots developing during the first several weeks of your recovery. He or she may recommend that you continue taking the blood thinning medication you started in the hospital. Notify your doctor immediately if you develop any of the following warning signs.

Warning signs of blood clots. The warning signs of possible blood clots in your leg include:

  • Increasing pain in your calf
  • Tenderness or redness above or below your knee
  • New or increasing swelling in your calf, ankle, and foot

Warning signs of pulmonary embolism. The warning signs that a blood clot has traveled to your lung include:

  • Sudden shortness of breath
  • Sudden onset of chest pain
  • Localized chest pain with coughing

Preventing Infection

A common cause of infection following total knee replacement surgery is from bacteria that enter the bloodstream during dental procedures, urinary tract infections, or skin infections. These bacteria can lodge around your knee replacement and cause an infection.

After knee replacement, patients with certain risk factors may need to take antibiotics prior to dental work, including dental cleanings, or before any surgical procedure that could allow bacteria to enter the bloodstream. Your orthopaedic surgeon will discuss with you whether taking preventive antibiotics before dental procedures is needed in your situation.

Warning signs of infection. Notify your doctor immediately if you develop any of the following signs of a possible knee replacement infection:

  • Persistent fever (higher than 100°F orally)
  • Shaking chills
  • Increasing redness, tenderness, or swelling of the knee wound
  • Drainage from the knee wound
  • Increasing knee pain with both activity and rest

Avoiding Falls

A fall during the first few weeks after surgery can damage your new knee and may result in a need for further surgery. Stairs are a particular hazard until your knee is strong and mobile. You should use a cane, crutches, a walker, hand rails, or have someone to help you until you have improved your balance, flexibility, and strength.

Your surgeon and physical therapist will help you decide what assistive aides will be required following surgery and when those aides can safely be discontinued.

How do I Prepare for a Knee Replacement Surgery?

In my experience, successful knee replacement experiences start well-before the actual procedure. Finding a qualified professional to design your surgery prep exercise is essential to your success. Some type of exercise before surgery is essential to your success. The preparation process also includes designing your post-surgery exercise program so you go straight into action!

Similarly (or contrarily?), the unsuccessful replacement experiences start well-before the actual procedure as well. This is not a medical opinion, this is a general observation — I have seen two painful, unsuccessful knee replacement experiences and both of these people were overweight before the surgery and gained weight after the surgery. Body composition is a big deal when it comes to your knee joints. If you need to get to a healthier weight, try your best to start this process before surgery.

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Some information was gathered and used in this article from the American Academy of Orthopaedic Surgeons. That information is quoted. No copyright infringement intended — for educational purposes only.