Total Knee Replacement

Total knee replacement is the most commonly recommended surgery to patients who have advanced arthritis of the knee and continue to have pain and functional problems despite appropriate nonoperative treatments. Total knee replacements have been performed for more than 40 years and have shown to be very reliable at achieving the goal of reducing or even eliminating pain in the knee from advanced arthritis. By reducing or eliminating pain in the knee, function and quality of life can be improved as well (walking farther, ability to negotiate stairs without a rail, participating in weight bearing activities). Longer term studies (Lancet 2017) indicate that approximately 90% of knee replacements had not required revision surgery at 20 years. In other words, only 1in 10 had needed a new replacement surgery by 20 years. Bear in mind that these were replacements put in before 1996, and technology has improved since that time.

Outpatient Surgery

With multimodal pain management techniques, less invasive surgical techniques, and blood conservation strategies practiced by the physicians at Valley Surgical Suites, total knee replacement can be safely performed as an outpatient procedure in the vast majority of patients.

What are the typical results from knee replacement?

Once sufficient time has elapsed to recover, the vast majority of patients experience complete or nearly complete relief from pain in the joint that has been replaced. Functional abilities tend to improve as well with an ability to perform more activities, walk longer distances, and negotiate stairs better. Many patients feel that the knee feels more stable as well. Once you are recovered, we do not set any limits for walking distance, hiking, biking, or gym activities including weightlifting. We want you to return to full activity. Even skiing and tennis are ok.

What is a total knee replacement?

Your knee functions very much like a hinge at the junction of two bones, the femur and the tibia. The ends of the bones are covered with a thick cushion of hard, white cartilage. You are given only one coating of this cartilage in your lifetime. If it is damaged or worn away, the underlying bones rub together, producing the pain and inflammation characteristic of arthritis. “Arthritis” simply means an inflammation of a joint causing pain, swelling, stiffness, instability, and often deformity. Severe arthritis interferes with a person’s activities and limits his or her lifestyle.

The primary goal of total knee replacement is to relieve pain. It may also help to restore motion, straighten the limb, improve stability, and improve the function of the joint. In a total knee replacement, the surface of the knee joint is removed, and a variety of artificial implants are substituted to produce an almost normal prosthetic joint. This is accomplished by surgically shaving off the arthritic ends of the bones and replacing them with new metal and plastic surfaces. Your supporting ligaments, tendons, and muscles are retained, and the parts which are surgically implanted mimic the normal anatomy they replace.

Which patients should have total knee replacement?

The most common and compelling reason for a total knee replacement is arthritic pain. It is often chronic and disabling. Pain cannot be measured, and the degree or pain sufficient to justify surgery should be decided by the patient and the doctor together.

Painful and arthritic knees often become unstable and untrustworthy, causing falls and other injuries. Climbing stairs, arising from chairs, and extended walking become a challenge. The patient’s independence and self-determination are compromised, and the quality of their life will deteriorate. While most arthritic knees are the result of degenerative osteoarthritis, other conditions such as rheumatoid arthritis, trauma, prior surgeries, contractures, instability, and tumors can be relieved by total knee replacement.

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