You too may not be able to do your daily tasks properly due to knee pain, right? You may feel like you are tired of life because of the severe pain that comes when you get up from a chair, climb a flight of stairs, or walk a short distance. If this pain does not subside despite taking medication and undergoing various treatments, your doctor may have told you about knee replacement surgery. It is normal to feel a little scared when you hear this name. However, let's talk about everything in simple terms today.
What is a knee replacement surgery?
Simply put, a knee replacement surgery, or knee arthroplasty in medical terms, is the surgical removal of the worn and damaged parts of your knee joint and the replacement with an artificial joint (prosthesis) made of metal and plastic.
Think of it this way: our knees are like the hinges on a door. Over time, this hinge becomes rusty and worn out, making it difficult to open and close a door. When the cartilage in the knee joint wears out, it becomes difficult for us to walk or bend our knees. This surgery is like removing that old, rusty hinge and replacing it with a brand new one.
What are the main types of surgery?
Knee replacement surgeries can be divided into two main types. Your doctor will choose the most suitable type for you based on the extent of damage to your knee.
| Type of surgery | Description |
|---|---|
| Total Knee Replacement | This is the most common type. Here, all three main parts of the knee joint (the inner side, the outer side, and the part under the kneecap) are removed and an artificial joint is inserted. |
| Partial Knee Replacement | As the name suggests, this involves removing only one or two damaged parts of the knee joint and replacing them with artificial parts. This surgery is common among young people who have suffered knee damage due to an accident or sudden injury. |
What kind of people need a knee replacement?
A doctor may recommend this surgery if you have severe symptoms that cannot be controlled with other non-surgical treatments (e.g., medication, exercise). Such symptoms include:
- Unbearable joint pain .
- Stiffness , inability to bend or straighten the knee.
- Limited mobility, such as difficulty walking.
- Knee swelling.
The main cause of this condition is arthritis . Knee replacement is most common in people with osteoarthritis . People with other types of arthritis, such as rheumatoid arthritis, may also need this surgery.
Rarely, this surgery may also be necessary due to arthritis (post-traumatic arthritis) that occurs after a fracture in the knee due to a car accident, fall, or sports injury.
How do you prepare before surgery?
Your doctor and surgeon will give you detailed instructions on what to do before surgery. Typically, you will need to do the following:
- A complete physical examination to see if you are healthy enough to undergo surgery.
- Several blood tests .
- An ECG (Electrocardiogram) test to check the functioning of the heart.
- A dental examination to reduce the risk of infection after surgery.
- An X-ray of the knee. You may also be asked to have an MRI or CT scan .
Most importantly, tell your doctor about all medications you are taking (including vitamins and herbal remedies). You may be advised to stop taking some medications a few days before your surgery.
Your doctor will also tell you how long you should stop eating and drinking the day before your surgery. Generally, you should avoid eating and drinking for 12 hours before your surgery.
What happens during the surgery?
On the day of the surgery, you will be given anesthesia so that you will not feel any pain. The anesthesiologist will either give you general anesthesia , which puts you completely to sleep, or regional anesthesia, which numbs only the area below the waist.
During the operation, the surgeon will do the following:
1. Damaged and worn out cartilage and bone fragments are removed.
2. Instead, a prosthetic joint is inserted.
3. A plastic spacer is inserted to act as a soft cushion in place of the removed cartilage.
4. If necessary, your kneecap (patella) will be reshaped to fit the new artificial joint.
This surgery usually takes about an hour or two.
How to recover quickly after surgery?
After surgery, you will be moved to a recovery room. The medical team will monitor you until you fully recover 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 up to a year to fully recover. But don't worry , you can usually resume most of your daily activities after about six weeks. Here are some things you can do to help you recover quickly:
- Apply ice: Applying ice to your knee for about 20 minutes several times a day can help reduce pain and swelling.
- Keep your leg elevated: Whenever possible, keep your leg elevated above the level of your heart by placing it on pillows.
- Keep the wound clean: Follow your surgeon's instructions exactly. Ask about how to change the wound bandage and when you can shower.
- Home exercises: Do the exercises your doctor prescribes exactly. These will help strengthen the muscles around your knee and prevent stiffness in your knee.
- Physical Therapy: You will need to work with a physical therapist for several months after surgery. They will help you safely bend your knee and begin walking.
How to control pain?
It is normal to feel some pain after surgery, especially in the first few weeks. Take the painkillers, NSAIDs (nonsteroidal anti-inflammatory drugs), and paracetamol as prescribed by your doctor. If the pain is unbearable or you have any questions about the medication, talk to your doctor.
What are the possible complications of this surgery?
Although knee replacement surgery is a very successful procedure, like any surgery, there are some risks. However, these are very rare.
- Blood clots
- Infection inside the wound or knee
- Damage to nerves or blood vessels
- Problems with the artificial joint (rapid wear, loosening)
- Stiffness due to scar tissue inside the knee
If you have other medical conditions such as diabetes , hemophilia , or lupus , be sure to tell your doctor about it before surgery.
If you have these symptoms, call your doctor immediately!
If you experience any of these symptoms after returning home from surgery, call your doctor without delay.
- Chest pain
- Difficulty breathing (Dyspnea)
- Fever greater than 101 Fahrenheit (39 Celsius)
- Excessive bleeding or pus-like fluid leaking from the wound
- Swelling, redness, warmth, or odor at the wound site
- New or worsening pain in the hip, ankle, or foot
- Severe pain that does not subside despite taking painkillers
In case of sudden chest pain or difficulty breathing, go to the nearest hospital Emergency Department (ETU) immediately.
Take-Home Message
- Knee replacement surgery is a very successful solution for severe knee pain that is not relieved by other treatments.
- The results of this surgery last for 10-15 years or even longer for most people.
- To recover quickly, it is essential to do physical therapy and exercises exactly as recommended by your doctor.
- Talk openly with your doctor about any questions or fears you may have before and after surgery.
- Following the post-surgery instructions exactly can greatly reduce the risk of complications.
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