Total knee replacement (TKR) surgery is a procedure in which the entire knee joint is replaced with an artificial prosthesis. Known to be the most common joint replacement surgery, a TKR is designed to improve the function of the knee.
TKRs alleviate arthritic pain typically resulting from:
- Osteoarthritis: The breakdown of the cartilage that covers the end of the bone in a joint
- Post-traumatic arthritis: A form of osteoarthritis that develops following injury to the joint, such as a ligament tear or a fracture
- Rheumatoid arthritis: A chronic inflammatory disorder in which the immune system attacks the joints in the body
When Is Total Knee Replacement Necessary?
A TKR is the last option for arthritic patients after all other conservative treatment modalities have failed. These could include:
- Exercise to improve movement of the knee
- Injections to manage pain
- Weight loss to reduce stress on the knee
- Medications to manage inflammation and pain
What Should Be Expected Prior to Total Knee Replacement Surgery?
Prior to a TKR, there are many steps that need to be taken by both surgeon and patient to ensure the greatest possible success during and after surgery. These steps include:
- Getting all secondary or underlying conditions (through means of medication or lifestyle change) under control
- Understanding why the arthritis has formed, especially with types of inflammatory arthritis such as rheumatoid
- Participating in prehabilitation, if applicable. (Prehabilitation is a form of strength training prior to surgery that helps prevent injury after surgery)
- Maintaining proper dental hygiene. Patients with poor dentition have a higher risk of infection in their mouths, which can potentially spread to other parts of the body
- Taking a pre-operative course, depending on the hospital. The course–which includes handouts for reference—helps patients fully understand what to expect. It is typically done concurrently with pre-operative testing. It will include tips, such as:
- No eating or drinking the night before
- Stop smoking and alcohol consumption
- Wash with special soap the night before surgery to help avoid infection
What Should Be Expected Following a Total Knee Replacement Surgery?
Though it will be fully explained in the pre-operative course, there are certain things patients can expect during their hospital stay (which is typically one to three nights).
Initial 24 Hours
- For the first 24 hours, patients will take an antibiotic to reduce the risk of infection
- Within hours after surgery, patients should expect to physically move around
- Within 24 hours after placement, a urinary catheter will be removed (if inserted)
Course of Hospital Stay
- Patients will receive education about incisions and dressings. In doing so, patients and caretakers may learn how to properly clear and maintain the surgical site while it heals
- The hospital staff (including the surgeon) will do everything in their power to effectively manage pain
Once patients are discharged, they can anticipate certain expectations during their long-term recovery.
First Four to Six Weeks
- No driving following the surgery
- Depending upon individual stability, moving away from an assisted device (e.g., crutches, walker)
First Three Months
- Supervised therapy following surgery
- Avoid high-impact activities, such as running, jumping or contact sports. Though the knee is artificial, it does not mean that it can sustain long-term heavy use
Important note: Patients must be actively engaged in their recovery. Without that commitment, the rate of healing can decrease drastically due to improper care.
We Are the Joint Specialists
At Northeast Orthopedics and Sports Medicine (NEOSM), our team of orthopedic physicians specializes in all aspects of joint care, including comprehensive diagnosis and treatment of knee conditions. As a practice, we are committed to utilizing the latest advancements to ensure patients receive the highest quality of care possible.
For more information or to schedule an appointment with one of our specialists, contact us today.