Do you also have difficulty getting up from a chair, climbing stairs, or walking for a short distance due to knee pain? Do you feel stiff and unable to bend or straighten your knees when you wake up in the morning? Does this pain increase day by day, not decrease? Most of the time, problems like this occur when the cartilage in the knee joint wears down. If you have tried various treatments for this, but the pain is getting worse and worse, your doctor may have told you about knee replacement surgery. Hearing this name may have scared you. But don't be afraid. Today, we will talk about everything about this, very simply, in a way that you can understand.
What is this knee replacement surgery?
Simply put, a knee replacement surgery involves removing the worn-out, damaged parts of your knee joint and replacing them with an artificial joint (prosthesis) made of metal and plastic. It's like taking a tire off an old car and putting a new one on. In medical terms, we call this surgery 'Arthroplasty'. This is done by an Orthopedic Surgeon, a specialist in bones and joints.
Who needs knee replacement surgery?
Usually, a doctor will first prescribe painkillers and physiotherapy for knee pain. However, if none of these treatments reduce your pain, stiffness, and swelling, and if the condition is so severe that you are unable to perform your daily activities, your doctor may recommend surgery.
The main reason why many people need this surgery is knee arthritis . This is when the soft cartilage between the joints wears down and the bones rub against each other. This condition often occurs with age. In addition, if the knee has been severely damaged in an accident and has developed post-traumatic arthritis, even a young person may need this surgery.
What are the main types of surgery?
Depending on the extent of your knee damage, your doctor will choose the type of surgery that is best for you. There are two main types.
| Type of surgery | Description |
|---|---|
| Total Knee Replacement (TKR) | This is the most common type. Here, all three major damaged parts of your knee joint (the inner side, the outer side, and the part under the kneecap) are removed and a completely artificial joint is implanted. This is also called Total Knee Arthroplasty (TKA). |
| Partial Knee Replacement (PKR) | As the name suggests, this type of surgery does not replace the entire knee joint. If only one or two parts of the joint are damaged, only those parts are removed and artificial parts are inserted. This type of surgery is often performed on young people who have damaged their knees in an accident. |
How do you prepare before surgery?
Since this is a major surgery, you will be given several tests beforehand to see if your body is ready for it. Your doctor will explain all of this to you.
The most important thing is to tell your doctor about all the medications you are taking (medicines for other illnesses, vitamins, traditional medicines) and any allergies you may have , without hiding anything .
Here are some of the tests that are usually required:
- Dental checkup: You may wonder why this is done. Think about it, germs from your mouth could enter your bloodstream after surgery and cause an infection in your new knee. This is done to reduce that risk.
- A complete physical examination: Check if your body is in a suitable condition for surgery.
- ECG test (Electrocardiogram): Checks the function of your heart.
- Blood tests: Check things like blood sugar and kidney function.
- Imaging tests: An X-ray of the knee will definitely be done. You may also be asked to do an MRI or CT scan.
Also, the day before the surgery, it is best not to eat or drink anything from the time the doctor tells you. Usually, you are asked to fast for 12 hours before the surgery.
What happens during the surgery?
Although there are slight differences depending on whether you are having a TKR or PKR surgery, these are the general steps involved:
1. Anesthesia: First, an anesthesiologist will give you pain medication. You may be put completely to sleep (General Anesthesia) , or you may be numbed from the waist down (Regional Anesthesia) . You will not feel any pain.
2. Removing the damaged parts: Next, the surgeon opens the knee and carefully removes the worn-out cartilage and bone fragments.
3. Implantation of the artificial joint: In the place of the removed part, metal artificial parts (implants) made to fit your joint exactly are inserted.
4. Plastic spacer: Then, a special plastic spacer is inserted between the two metal parts, which acts like our own cartilage. This is what allows the new joint to move smoothly and painlessly.
5. Kneecap Adjustment: If necessary, your kneecap (patella) will be reshaped to fit the new joint.
This entire surgery usually takes about an hour or two .
What are the benefits and risks of this surgery?
Like any surgery, this one has benefits and very small risks. It's important to be aware of that.
| Benefits | Risks - (These happen very rarely) |
|---|---|
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Don't worry, these risks are very rare, and your medical team will do their best to prevent them.
What happens after the surgery? How long is the recovery time?
After surgery, you will be moved to a recovery room. The medical team will monitor your heart rate and blood pressure until you have fully recovered from the anesthesia. Some people can go home the same day, but most people will need to stay in the hospital for a day or two.
It can take several months to a year to fully recover. However, you should be able to do most daily activities in about six weeks . This time depends on your age, how active you were before surgery, and other medical conditions.
Things to follow during recovery
This time is a little difficult, but your enthusiasm and dedication will speed up your recovery.
- Exercise: You should do the exercises exactly as instructed by your doctor and physiotherapist. You should start doing these from the very beginning.
- Elevate your knees: Whenever possible, keep your knees elevated above your heart by placing them on pillows. This will help reduce swelling.
- Ice: Apply an ice pack to the wound for about 20 minutes several times a day. This will greatly reduce pain and swelling.
- Keeping the wound clean: Keep the wound clean and dry. Change the dressing only as directed by your doctor. Also ask when you can shower.
- Physiotherapy: This is extremely important . With the help of a physiotherapist, you need to learn to bend your knee properly and walk. This will take several months.
Preparing the home environment
Before you go home, it is very important to make your home environment comfortable for you.
- Install grab bars on the toilet and bathroom so you can grab them and get up.
- Remove anything that could slip and fall, such as rugs and wires left lying around on the floor.
- Check if the handrails on the stairs are strong.
When to see a doctor as soon as possible
If you experience any of the following symptoms, call your doctor immediately or go to the hospital's Emergency Department (ETU).
| Warning signs to look out for | |
|---|---|
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Having a knee replacement surgery is a big decision. It's normal to have questions and concerns about it. Discuss any concerns or fears you have with your doctor. The recovery period can be a bit of a struggle, but the rewards are well worth it. There's nothing better than being able to enjoy your work again after years of pain.
Take-Home Message
- Knee replacement surgery is a very effective and safe treatment for severe knee pain.
- It takes time to fully recover from surgery, and your dedication and enthusiasm are essential.
- Physiotherapy is a very important part of the recovery process and should never be skipped.
- Follow the doctor's instructions exactly, especially regarding taking medication and caring for the wound.
- If any warning symptoms (fever, severe pain, wound infection) appear, seek medical advice without delay.
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