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Total Knee Replacement

When knee pain doesn't respond to more conservative treatments and disrupts your daily life, knee replacement surgery is an option.

Also known as arthroplasty, knee replacement surgery is a safe and effective way to relieve joint pain and fix deformities so you can resume your daily activities.

Why knee replacement is done

The decision to have knee replacement surgery is between you and your orthopaedic surgeon, who will do an evaluation to determine if it's a procedure that will benefit you. 

There are different types of knee replacement surgery, including:

The video below illustrates a total knee replacement procedure:

The most common reason for knee replacement is arthritis, including:

  • Osteoarthritis, a degenerative joint disease that affects mostly middle-aged and older adults, may cause the breakdown of joint cartilage and adjacent bone in the knees.
  • Rheumatoid arthritis, which causes inflammation of the synovial lining of the joint and results in excessive synovial fluid, may lead to severe pain and stiffness.
  • Traumatic arthritis - arthritis due to injury - may also cause damage to the articular cartilage of the knee and avascular necrosis of the knee.
  • Patellofemoral arthritis

Knee replacement is recommended when:

  • You have severe pain and/or stiffness that interferes with your daily life. You find it difficult to stand up or sit down, and walking more than a few blocks without a cane or walker causes you pain.
  • You have knee pain while at rest.
  • Your knee has chronic inflammation and swelling that isn't helped with medications or rest.
  • Your knee has become deformed.
  • Conservative treatments, such as anti-inflammatory medications, physical therapy or cortisone injections, aren't effective.

Who needs knee replacement?

Your age or weight are not factors in determining whether you should have knee replacement surgery.

The primary considerations are your level of pain and disability.

The majority of patients who have the procedure are between the ages of 50 and 80, although patients of any age can be eligible for it.

Risks

As with any surgery, there are some potential risks when you have a knee replacement. Some of the possible complications of the procedure include:

  • Infection. An infection can occur either in the area of the incision or around the prosthesis.
  • Blood clots. This is the most common complication of knee replacement. Blood clots break free and travel to your lungs, which is life threatening.
  • Implant issues. Although implants have become more advanced over the years, surfaces may still wear down or components may loosen.
  • Blood vessel injury. Injury to the blood vessels during surgery is rare, but it is a risk.
  • Reactions to anesthesia.

What to expect

Before surgery

If you and your doctor have decided that you could benefit from knee replacement surgery, you will need to prepare. The time leading up to the procedure is a good time to get yourself and your home ready for recovery. Some things you may want to do include:

  • Medical evaluation. Before your procedure, your physician may recommend a complete physical in the weeks leading up to your surgery.
  • Testing. Your physician may recommend blood and urine tests, as well as an electrocardiogram.
  • Arrange transportation and home care. You will be able to walk with crutches or a walker soon after your surgery, but you may need assistance with things like bathing, cooking and other household chores. Arrange to have someone assist you at home.
  • Make home modifications. To make getting around your home easier while you recover, you may want to install assistive devices such as safety bars, hand rails and toilet seat risers. You may want to put a bench in your shower. Remove any tripping hazards from the home, including throw rugs and electrical cords.
  • Lose weight. If you are overweight, try to lose some before your procedure. This will decrease the amount of stress on your new joint. Pool exercise may be a good option.

The procedure

Knee replacement surgery involves removing a disease or injured knee and replacing it with an artificial joint. More than 99 percent of patients have dramatically less knee pain and an improvement in performing their daily tasks.

  • During the procedure, which is done under anesthesia, you will have your knee in a bent position. This is so all parts of the joint can be fully exposed.
  • Your surgeon will make an incision in the knee, move your kneecap aside and remove the damaged joint surface.
  • When the joint surfaces are ready, your surgeon will insert and attach the artificial joint.
  • Before your knee is closed, the surgeon will bend and rotate it to ensure that it is working properly.

The entire procedure lasts about 90 minutes.

When your procedure is complete, you will be taken to a recovery room for observation. Once your vital signs are stable and you are alert, you will be taken to your hospital room. Most patients stay for two days before going home.

After surgery

While you are recovering in the hospital, you will be encouraged to move your ankle and foot to prevent swelling and blood clots.

Your doctor may also recommend blood thinners and support stockings to further prevent blood clots and leg swelling.

The day after your surgery, a physical therapist will work with you to exercise your new knee. Your physical therapist will also help you design an exercise program to follow once you are discharged.

At home

Your chances of recovery are best when you follow all of the recommendations of your doctor and physical therapist. To ensure a smooth and complete recovery:

  • Keep the incision clean and dry.
  • Eat a balanced diet to help your wound heal and regain your muscle strength.
  • Follow an activity program. Most exercise programs following knee replacement surgery will include graduated walking, knee-strengthening exercises and an eventual return to normal household activities. Avoid high-impact activities.

Within six weeks, you should be able to go back to light activities and driving. You may feel a soft clicking in the joint when walking or bending. Continue to the work with your physical therapist. Water-based exercises may help to improve joint pain, swelling around the knee and range of motion.

When to call your doctor

After you leave the hospital, contact your doctor if any of the following occurs:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding or discharge from the incision site
  • Pain that you cannot control with medication
  • Nausea and /or vomiting that you cannot control with the medicines you were given after surgery, or which persist for more than two days after discharge from the hospital
  • Cough, shortness of breath or chest pain
  • Your leg, foot or  toes appear chalky white, blue or black
  • Numbness or tingling in your leg, foot or toes
  • Pain, burning, urgency, frequency of urination, or blood in the urine
  • Swelling, redness, or pain in your legs, calves, or feet

In case of an emergency, call for medical help right away.

To learn more, call 714-456-7012 or schedule an appointment online ›

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