You do not have to live with a painful knee for the rest of your life. During knee replacement surgery your problem knee joint is replaced with an artificial joint (a prosthesis). After a total knee replacement, you can look forward to moving more easily and without pain.
A knee replacement is an elective surgery, replacing the bottom end of the femur and the top end of the tibia with a man made device (prosthesis). The back surface of the patella is also commonly resurfaced. Total knee replacement is not a complete solution to the problem as they become loose with time and may need to be revised (which means another operation) within ten to fifteen years.
These artificial joints are combinations of metal and plastic and sometimes ceramic materials. They are fixed to the bone either using bone cement or by using a prosthesis with a rough surface, which relies on your bone growing on to the implant for long term stability. It may be reinforced with screws on the tibial side. In between the two components is a special plastic liner made out of polyethylene.
Patients who have arthritis on their X-ray and pain and stiffness from their knee joint that causes:
Knee replacement procedures have come a long way since their beginning in Ancient Egypt. They are now a very commonly performed procedure and advancements continue to be made.
However, there are risks in any operation. You can read about the general complications here. Some complications specific to total knee replacement are:
You will be required to attend a pre admission clinic. Everything you need to know about what to do before, during and after your stay in hospital will be discussed at length at this clinic. Your doctor will also examine you and ask you questions, and you should let them know if you have any abrasions or pimples around the knee.
At this clinic the following will be attended to:
You will have simple blood tests to make sure your blood count is normal and you have no other major medical problems. Because knee replacement is such a major operation with drilling and cutting involved there is a higher risks than in most operations of the health care team catching diseases transmitted by blood. For this reason, a sample of your blood will also be tested for AIDS and hepatitis. The results of this test can take up to two weeks.
A cardiograph of your heart will be taken to make sure you have no underlying cardiac problems. An ECG is non-invasive - no needles, just some stickers on your body that communicate to a machine through wires.
Your doctor may or may not require new X-rays of the knee he is operating on.
This is required to make sure you do not have a urinary tract infection. An infection anywhere before surgery e.g. infected toenail, skin lesion, throat infection, gum or dental infection, can greatly increase your chances of infection of the joint replacement following surgery. If an infection is found, it can be treated with simple antibiotics prior to surgery.
Most patients return to sedentary jobs at 3-6 months after total knee replacement. It must be stressed to the patient before surgery that they may not return to manual labour after joint replacement. Any heavy manual job will result in premature loosening of the joint replacement and pain due to the increased stress on the joint replacement. Clerical or supervisory duties are suitable for a patient with a total knee replacement.
When you feel comfortable using your leg fully. For most people, they feel comfortable driving after six weeks. Please also check with your insurance company as they may have specific rules on when you can drive after surgery.
Sexual intercourse is allowed when the patient is comfortable but they have to be in charge of the positions used and any significant discomfort should result in the patient abstaining until they talk to their doctor.
In general, sexual intercourse occurs at around three to six weeks post operatively.
Obviously, pounding sports are not good for joint replacement as they can wear the articulation. We recommend walking, bushwalking, swimming, stationary bike riding, doubles tennis and skiing on groomed runs if the patient is already a good skier. Jogging and heavy weights, although possible, will wear the joint prematurely.