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Knee Replacement

(Knee Arthroplasty; Total Knee Replacement)

Definition

Knee replacement is surgery to replace a knee that is damaged by disease or injury. It is also called arthroplasty.
Total Knee Replacement
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Reasons for Procedure

This surgery is done in people who have knee pain that limits activities. The pain may be from arthritis or injury. Surgery may also be done to correct a knee that is bowing in or out.

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
  • Infection
  • Excess bleeding
  • Blood clots
  • Problems with the implant
  • Pain that does not get better
  • Damage to nearby nerves or blood vessels around the knee
Things that may raise the risk of problems are:
  • Smoking
  • Chronic health problems, such as diabetes and obesity

What to Expect

Prior to Procedure

Images of the knee will be taken to help choose an implant. This can be done with:
Before surgery:
  • Arrange for a ride to and from the hospital.
  • Do not eat or drink anything after midnight the day before surgery.
  • Talk to the doctor about any allergies you have.
  • Talk to the doctor about the medicines, herbs, and supplements that you take. Some may cause problems during surgery or recovery. They may need to be stopped up to one week before surgery.
  • Arrange for help at home while you recover.
  • Prepare a bedroom on the first floor if possible. Climbing stairs will be hard at first.

Anesthesia

General anesthesia will block pain and keep you asleep. Regional anesthesia may be used to numb the lower part of the body.

Description of the Procedure

A cut will be made in the skin. The damaged cartilage and bone will be removed. The bone that is left will be prepared to receive the new joint. It is made from material such as plastic and metal. The artificial joint will be placed in the correct place. It may be cemented within the bone. The incision will be closed with staples. A drain will be left in to allow extra fluid to flow out.

How Long Will It Take?

About 2 hours.

How Much Will It Hurt?

Anesthesia will block pain during surgery. There will be pain during recovery. Medicine and home care can help.

Average Hospital Stay

This procedure is done in a hospital setting. Most people stay for 3 to 4 days. People who have problems may need to stay longer.

Post-procedure Care

At the Hospital
After the procedure, the staff will:
  • Give pain medicine
  • Take an X-ray of the joint replacement if needed
  • Put compression stockings on the legs to lower the risk of blood clots
  • Wrap the knee with a cold pack to ease pain and swelling
  • Ask you to move your foot and ankle to promote blood flow
  • Teach you how to use a walker , crutches , or other support devices
At Home
It will take several weeks to months for the incision and joint area to fully heal. Exercises will help with recovery. Some physical activities will need to be limited. Help will be needed to do daily tasks. Returning to work may take six weeks or more.
Antibiotics may be needed before dental procedures and surgeries. This helps lower the risk of infection in the new joint.

Call Your Doctor

Call the doctor if you are not getting better or you have:
  • Signs of infection, such as fever and chills
  • Pain that you cannot control with medicine
  • Nausea and vomiting
  • Redness, swelling, pain, a lot of bleeding, or discharge from the incision
  • Swelling, redness, or pain in your legs or feet
  • A chalky white, blue, or black appearance in your leg, foot, or toes
  • Numbness or tingling in your leg, foot, or toes
  • Cough, shortness of breath, or chest pain
  • Problems urinating or blood in the urine
If you think you have an emergency, call for medical help right away.

RESOURCES

American Orthopaedic Society for Sports Medicine
http://www.sportsmed.org
Ortho Info—American Academy of Orthopaedic Surgeons
http://orthoinfo.org

CANADIAN RESOURCES

Canadian Orthopaedic Association
http://www.coa-aco.org
Canadian Orthopaedic Foundation
http://www.canorth.org

References

Knee replacement surgery procedure. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/health/conditions-and-diseases/arthroscopy. Accessed March 27, 2020.
A patient's guide to total joint replacement and complete care. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/ccf/media/Files/Ortho/patient-education/total-joint-replacement-patient-guide.pdf?la=en. Updated 2015. Accessed March 30, 2020.
Total knee arthroplasty. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/total-knee-arthroplasty . Updated January 11, 2020. Accessed March 27, 2020.
Total knee replacement. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00389. Updated August 2015. Accessed March 27, 2020.

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