Total Knee Replacement Basics
This section is meant to be a very rudimentary introduction to total knee replacements. There are many excellent resources available if you are comtemplating a total knee replacement. One source of information I like is from Stryker. First of all, there is a lot of information on their website about various options to help with knee pain, including total knee replacement. Secondly, through their website I was able to view a live operation to do a total knee replacement (not for the faint of heart!). Bear in mind that Stryker is but one of several manufacturers of knee replacement hardware.
During a typical total knee replacement essentially all the muscles in and around your knee are abused. They will be sore after the operation. The top of your tibia (shin bone) is shaved or cut off, and replaced with a metal/ceramic/plastic cap that is usually screwed into place. The end of your femur (thigh bone) is cut off, and replaced with a metal/ceramic/plastic device that is screwed and/or glued into place. These metal devices will rest on and rotate on a thin disc inserted between them. Your patella (knee cap) will be left, partially removed and patched, or totally replaced depending upon its condition. All this is why I hesitated for a few months before finally deciding to go ahead with my total knee replacements. I am very happy with my decision.
Right now I have both of my knees replaced (the first in May, 2006, and the second in August, 2006). I have been told that the experience of having a total knee replacement varies widely from person to person, and even for the same person (two knees replaced, two different experiences). So the information I provide is based on only two examples plus a few comments from friends.
- Total knee replacements work far more often than not, and can nearly eliminate knee pain while maintaining or enhancing functionality.
- A total knee replacement can restore normal full functionality to your knee. You can go up and down a reasonable number of stairs, walk, shop, drive, etc., without pain. You can even work out on an elliptical exercise device.
- Total knee replacements now last (on average) more than 20 years.
- My limited sample of those who have had one or two total knee replacements is very positive. I include myself in this list.
- If you have your knees monitored regularly (xray about every two years), the first signs of deterioration of the disk in the middle can be detected. The operation to replace this disk is far easier than the original total knee replacement.
- A total knee replacement can not restore extreme functionality. You will no longer be able to dance ballet, walk up 209 stairs every day (I actually do this once a year), sit on your heels, jog, use a treadmill, do extreme yoga, run marathons, etc.
- Make no mistake, a total knee replacement is a big operation and your recovery will take four weeks (minimum) before you can drive again, and a full year before the last lingering symptoms of the operation are fully gone.
- It takes hard work on the part of the patient to do the physical therapy and exercises to return to full knee functionality.
- There is pain in the first weeks following the operation. This can mostly be controlled, but some discomfort will persist for several weeks.
- Complications can rarely occur, including blood clots, unsatisfactory results, etc. The operation is a major operation.
- You need someone to take you to and from the hospital. You need someone to take care of you for at least the first month after the operation. If your right knee is replaced, you cannot drive for at least a full month.
- Approximately 0.5% (one half of one percent or 1 out of 200) total knee replacements need correction during the first ten years after surgery. That means 5% of total knee replacements will need some additional surgery (called revision surgery) within the first ten years.
- If you do not do you physical therapy and exercises, and walk regularly after a total knee replacement, you run a serious risk of ending up in a wheel chair.