Knee Replacement – Should You Have One? | Orthopaedic Institue of Ohio

When standing up is more difficult than it used to be or you’re wearing a brace for every trip to the grocery store, you might be wondering if it’s time for a knee replacement. While it’s not the go-to solution for all knee-related problems, there are reasons to consider if knee arthroplasty is in your future.

According to the American Academy of Orthopaedic Surgeons (AAOS), over 600,000 knee replacement surgeries are performed in the United States each year, with that number steadily increasing due to an aging population, an increase in obesity and an increase in the number of people with knee arthritis.

Keep reading to learn more about common knee replacement types, if you’re a candidate for one and how long they last after the procedure is performed.

What Is Knee Replacement Surgery?

Knee replacement, also known as knee arthroplasty, is a surgical procedure in which the damaged parts of the knee joint are removed and replaced with artificial parts or prostheses. The prostheses are typically made of metal and plastic and are designed to mimic the function of a healthy knee joint.

It’s typically only considered after all, or most nonsurgical options have been exhausted and if your quality of life is significantly impacted by the pain.

Types of Knee Replacements

There are several types of knee replacement surgery available, including:

Total knee replacement (TKR): The most common type, which involves removing the damaged parts of the knee joint and replacing them with artificial parts, or prostheses, that typically consists of a metal component that replaces the thigh bone (femur) and a plastic component that replaces the shin bone (tibia).
Partial knee replacement (PKR): Also known as unicompartmental knee replacement, it involves replacing only the damaged part of the knee joint rather than the entire joint and is typically recommended for individuals with arthritis that is confined to one compartment of the knee.
Revision knee replacement: A type of knee replacement surgery performed when a previous knee replacement surgery has failed or has become loose. It involves removing the previous prosthesis and replacing it with a new one.
Customized knee replacement: This type of knee replacement surgery is done by using a CT scan of the patient’s knee and using the data to create a prosthesis that is customized to the patient’s individual knee anatomy.
Minimally invasive knee replacement: This type of knee replacement surgery is done through a smaller incision, which can reduce recovery time and minimize tissue trauma.

Underlying Causes

Knee replacement surgery is typically recommended for individuals with severe knee pain or disability caused by osteoarthritis, rheumatoid arthritis, or other similar conditions. Not everyone with knee arthritis will need a knee replacement, and the decision is typically based on the balance between the pain and disability caused by the knee problem and the risks and benefits of the surgery. Your doctor will consider your overall health and your goals for treatment.

Osteoarthritis is the most common reason for knee replacements, which is a degenerative condition that causes the cartilage in the knee joint to wear away. Rheumatoid arthritis, another main reason for replacement, is an autoimmune disorder that causes inflammation in the joints.

Other conditions that can lead to knee replacement surgery include trauma or injury to the knee joint that has caused damage to the cartilage or bones, gout, a type of arthritis caused by the buildup of uric acid crystals in the joint, osteonecrosis, where the bone tissue dies due to a lack of blood supply and pseudogout, a type of arthritis that causes a buildup of calcium pyrophosphate crystals in the joint.

What Are the Signs You Might Need a Knee Replacement?

Signs that may indicate a need for a knee replacement are:

Severe pain: Pain in the knee joint that interferes with daily activities and is not relieved by over-the-counter pain medication.
Stiffness: Difficulty in moving the knee joint or feeling stiffness in the joint, especially in the morning or after sitting for long periods.
Swelling: Inflammation and swelling in the knee joint which can make the knee appear red and warm to the touch.
Bone-on-bone: A feeling of bone grinding on bone in the knee joint, which can be accompanied by a clicking or popping sound.
Loss of function: Difficulty in standing up, climbing stairs, or walking, which can make it hard to perform daily activities.
Deformity: A visible deformity in the knee joint, such as a bowlegged or knock-kneed appearance.

One or Both at the Same Time?

It is possible to perform knee replacement surgery on both knees simultaneously, a procedure known as bilateral knee replacement. This approach can be beneficial for some patients, particularly those with severe arthritis in both knees or those who are unable to perform daily activities due to the pain in both knees.

However, bilateral knee replacement is considered a more complex surgery requiring longer recovery. It also requires a higher level of postoperative care and an increased risk of complications. Therefore, the decision to perform bilateral knee replacement will depend on the specific condition of the patient’s knees, the patient’s overall health and lifestyle, and the surgeon’s experience and expertise.

It’s important to note that most patients opt to have one knee replacement done at a time, with the second one done a few months after the first one. This is done to minimize the risk of complications and allow recovery before the second knee replacement surgery. Your surgeon will discuss the options most suitable for you based on your individual needs and circumstances.

Is Replacement Your Only Option?

Alternative remedies that may be tried to manage knee pain and improve the function of the knee joint may include:

Physical therapy: A physical therapist can develop a personalized exercise program to help strengthen the muscles around the knee and improve the range of motion.
Weight management: Losing weight can reduce stress on the knee joint and help alleviate pain.
Bracing: Wearing a knee brace can help support the knee joint and alleviate pain.
Acupuncture: This traditional Chinese medicine technique involves the insertion of thin needles into the skin at specific points on the body to relieve pain and improve function.
Chiropractic: Chiropractors use manual adjustments to help align the bones and joints in the body, which can alleviate pain and improve function.
Massage: A therapist can use massage techniques to help relax the muscles and reduce pain in the knee joint.
Nutritional supplements: Some supplements, such as glucosamine and chondroitin, can help reduce inflammation and improve joint health.

The effectiveness of alternative remedies can vary from person to person. Consult with a healthcare professional before starting alternative remedies. Some of these may interact with medications or may not be appropriate for individuals with certain medical conditions.

How Long a Knee Replacement Lasts

The lifespan of a knee replacement can vary depending on the type of implant used, the patient’s activity level, and the patient’s weight, but a typical knee replacement can last between 15-20 years. Knee replacements are not meant to last forever; revision surgery may be needed at some point. Your surgeon will closely monitor you post-operatively, and if any signs of wear and tear or looseness in the implant are detected, revision surgery may be recommended.

Some knee replacements can last even longer, up to 25-30 years, while some may need to be revised earlier. For example, if the patient is overweight, engages in high-impact activities or has a high level of physical activity, the implant may experience more wear and tear, leading to a shorter lifespan. Conversely, if the patient can maintain a healthy weight and if the patient’s activity level is low, the implant may last longer.

Overall, knee replacement surgery can be a highly effective treatment for knee pain and disability caused by knee joint conditions, and the goal of the surgery is to improve the patient’s quality of life, but the patient should be aware of the fact that a knee replacement is not the only option and may not be for everyone.

Who is a Good Candidate for Knee Replacement Surgery?

Even if your knee shows symptoms of needing a replacement, not everyone is a good candidate for replacement surgery, perhaps due to certain medical conditions or other factors, including:

Advanced age may cause some to not be able to tolerate surgery or may not be able to recover as well. Knee replacements are becoming more common in younger patients, as well as those who are more active.
Obesity and severely overweight people may not be good candidates for knee replacement surgery because of a higher risk of complications during and after the surgery.
Active infections anywhere in their body may need to wait for surgery until treated and cleared.
Severe osteoporosis may cause a higher risk of complications during and after the surgery.
Certain psychological conditions affect the ability for some to make decisions or follow through with postoperative rehabilitation.
Other diseases: Individuals with rheumatoid arthritis, lupus, or other connective tissue disorders may not be good candidates.

While these factors are not absolute contraindications for knee replacement surgery, each case is evaluated individually. Your doctor will consider the condition of your knee and your overall health and lifestyle.

Recovery After

Improvements in surgical techniques, implant materials and post-operative rehabilitation have allowed for better outcomes and a quicker return to normal activities, even in younger patients.

The recovery process can vary depending on the individual and the type of surgery performed, but physical therapy is usually a crucial part of the recovery process. It’s important to follow your surgeon’s instructions and attend all follow-up appointments to ensure the best outcome for your surgery. Recovery time can vary, but most people can return to normal activities within 3-6 months after surgery and typically includes:

Pain management: Pain medication will likely be prescribed to manage pain during recovery.
Physical therapy: Physical therapy is a crucial part of recovery. A therapist will work with you to help you regain strength and range of motion in the knee joint.
Rest and elevation: It is important to rest and elevate the knee to reduce swelling and inflammation.
Compression: Wearing compression stockings can help to reduce swelling in the knee joint.
Incision care: You will be given instructions on how to care for the incision site, including how to keep the area clean and dry, and how to monitor for signs of infection.
Medications: You will be prescribed antibiotics and blood thinners to prevent blood clots and infection.
Follow-up appointments: You will have follow-up appointments with your surgeon to monitor your progress and address any concerns you may have.
Return to activities: Returning to normal activities will depend on how well you are healing and how quickly you are regaining your strength and mobility. Your surgeon will provide you with guidelines on when you can safely return to work, drive, and resume normal activities.
Lifestyle changes: Your surgeon will advise you on lifestyle changes, such as maintaining a healthy weight and avoiding high-impact activities, which can help prolong the implant’s life.

Get a Customized Consultation for Knee Pain in Ohio

Knee joint replacement can profoundly impact your quality of life overall, but there is much to consider. To learn more or find out if you are a candidate for total knee replacement, contact the Orthopaedic Institute of Ohio today at 419-222-6622.