There are times when one might face difficulty in walking as a result of knee damage. There arises a need for a knee replacement to replace a worn-out, damaged, or diseased knee with an artificial one. A knee replacement may be done in adults of any age; however, it is mostly required in people of age 60 to 80 years.
A small knee replacement operation is termed a partial knee replacement which is done in people aged between 55 and 64. This type of artificial joint requires redoing within the next 10 years. A knee replacement becomes necessary when it is worn out leading to reduced mobility and pain during rest.
You are required to have a knee replacement done when other treatments like physiotherapy and steroid injections don’t work. It is suggested when a person is in severe pain and has stiffness and swelling in the knee joint. The joint pain in such conditions reduce mobility and affects the quality of life.
What Is a Knee Replacement Surgery?
Knee replacement surgery or knee arthroplasty is a surgical procedure that is used for replacing the surface of the knee joint which bears weight to relieve pain or any disability. Generally, it is done in those suffering from osteoarthritis, rheumatoid arthritis or psoriatic arthritis.
Patients who suffer from a high level of deformity comprising advanced trauma, rheumatoid arthritis, and long-term osteoarthritis has a more complex surgery and are considered as cases of high risk. Knee replacement involves substantial post-operation pain and involves physical rehabilitation. The recovery period is generally 12 weeks or maybe longer depending upon case severity.
Such cases may need mobility aids such as crutches, canes or walking frames to facilitate the patients to reach their preoperative mobility level. There has been an estimation that shows that 82% of total knee replacements last up to 25 years.
Knee Replacement Surgery Procedure
Anyone going through a knee replacement requires to stay in hospital; the procedure varies depending upon the patient’s condition. This surgery is mostly done while the patient is asleep as a result of anaesthesia.
- A knee replacement surgery requires a patient to remove clothing and wear the given gown.
- An IV or intravenous line is started in the arm or hand and the patient is positioned on the operation table.
- A urinary catheter is inserted and in case the surgical site consists of excessive hair then they are clipped off.
- The anaesthesiologist monitors the heart rate, breathing, blood oxygen level, and blood pressure during the surgery.
- The skin covering the surgical site is cleaned with an antiseptic solution after which the doctor makes an incision in the knee area.
- The damaged surface of the knee joint is removed by the doctor and the knee joint is resurfaced with the help of a prosthesis. These are usually made up of plastic and metal. Commonly, an artificial knee prosthesis is a cemented prosthesis that is attached to the bone using surgical cement.
- The prosthesis comprises the tibial component, the femoral or the thigh bone component and the patellar component. The incision is closed with surgical staples or stitches. Once done, it is covered using a sterile bandage of dressing.
Knee Replacement Recovery Time Risks
Bleeding may occur during and after the knee replacement surgery which is considered normal. However, in rare cases, a patient might lose too much quantity of blood leading to the requirement of a transfusion. In some cases, the blood may collect under the skin leading to swelling which might require another process for releasing blood.
Blood clots are yet a risk that comes with knee replacement surgery. If a blood vessel gets damaged then the patient might not be able to move for numerous days after the surgery. This might lead to slower blood flow leading to a blood clot.
Pain and swelling occur after the surgery which may vary from person to person depending on the severity of the case. Patients might also experience swelling in the ankle, knee, and foot after the surgery.
Since the operation requires an incision, there is a risk of infection that may occur due to the entrance of a bacteria. This might result in swelling, redness, fever, warmth, discharge from the operation site, and chills.
Some other risks include allergic reaction to the metal components in knee replacements which might lead to rashes, blisters, and swelling. In some rare cases, it might lead to diarrhoea, headaches, and weakness.
Knee Replacement Risks
There are numerous risks present in knee replacement surgery. While some of these arise as an outcome of the surgery itself, the other risks may arise as results of the response of the patient’s body to the operation.
Patients are generally given anaesthesia so that they don’t feel the pain while operation. The anaesthesia may be a general one or a regional one, no matter which it is, there are certain side effects including headache, nausea, sore throat, drowsiness, allergic reactions, and heart attack.
While these are some of the normal risks, some patients facing breathing issues especially if they were given general anaesthesia during the procedure. In case of insufficient air reaching the lungs, mucus might build-up leading to pneumonia.
In rare cases, accidental blood vessel or nerve damage may occur which runs close to the knee. In such cases, a second surgery might be required to repair the damage done. There is also a risk of implant failure which includes a loose new joint, wearing out and leading the patient to feel continuous stiffness and pain.
Knee Replacement Exercises
There are numerous exercises that you must do to help increase circulation in your legs and feet. They help in preventing blood clots, strengthening muscles, and improving knee movement. These exercises must be started as soon as possible as they are very helpful.
These exercises may be started in the recovery room itself just after the surgery. At first, it might seem uncomfortable to practice these but with time it can be observed that the recovery process enhances and the postoperative pain reduces.
The first exercise is quadriceps sets, let’s see how it’s done. In this exercise, you are required to tighten the muscles of your thighs and hold the knees straight for 5 to 10 seconds. This exercise is to be repeated 10 times in two minutes with a one-minute break in between. This exercise is to be continued till your thighs feel tired.
Knee Straightening Exercise
Next is the knee straightening exercise, in this one, a small rolled towel is to be placed above your heel such that the heel doesn’t touch the bed. Once done, tighten your thigh and fully straighten the knees while touching the back of your knees to the bed. Hold it in a straight position for 5 to 10 seconds and repeat it until your thighs get tired.
The next exercise is ankle pumps, here are the steps to do it. In this exercise, you are required to move your foot up and down by contracting the calf and shin muscles. This exercise is to be performed for 2 to 3 minutes, 2 to 3 times in an hour while you are in the recovery room. This exercise is to be continued till you get fully recovered and the lower-leg and ankle swelling diminish.
Straight Leg Raises
The next exercise is straight leg raises, let’s read about its process. Place your knees fully straight on the bed while tightening the thigh muscle as it is done in the quadriceps. Now lift your leg to several inches and hold up to 5 to 10 seconds; once done slowly bring them down. Repeat this exercise until your thighs feel tired.
Leg raises may also be done in a sitting position. All you got to do is tighten your thigh muscles, hold knees straight without any support for 5 to 10 seconds and repeat. This exercise is to be repeated until your thighs feel fully strengthened.
Knee Bends Supported by Bed
This requires sliding your foot towards the buttocks, bending the knee, and keeping heels on the bed. Try holding the knee in a bent position for 5 to 10 seconds and then straighten. This exercise is to be repeated until you can fully bend your knee or your legs feel tired.
Knee Bends Supported by Sitting
Sit in a chair or by the bedside with supported thighs by placing the foot behind the heels of the operated knee for support. Now, bend the knees slowly as far as possible, hold and remain in this position for 5 to 10 seconds. This exercise is to be repeated till your legs feel tired or you can bend your knees fully.
Knee Bends Unsupported by Sitting
Sit in a chair or by the bedside with thighs supported, now bend the knees as far as you can until your foot can rest on the floor. Once your foot reaches the ground, slide your upper body forward to increase the knee bend. Hold this position for 5 to 10 seconds and then slowly straighten the knee fully. Repeat this exercise until you are completely able to bend your knee or your legs feel tired.
Once the knee replacement surgery gets completed, the patients can walk small distances in the hospital room. Not only this, they can do their everyday activities as well. This initial movement is necessary as it enhances the recovery process and helps the knee in regaining strength and mobility.
Walking is yet another way that helps the knee recover. Initially, the patient walks with the assistance of crutches or a walker. The weight that you need to let on your legs differs from the severity of the surgery.
The doctor will help you out with this and guide you throughout the process to aid your recovery. Generally, it is recommended that the weight must be evenly spread on the walker or crutches.
Climbing and Descending Stairs
Going up and down the stairs requires both flexibility and strength. Initially, you may take the help of the handrail to walk up and down the stairs one step at a time. One should always climb up with the good knee and come down with the operated knee. This helps in strengthening the knees and building endurance.
There are the initial exercises that are a must for patients who have gone through knee replacement surgery. Once these exercises are done by the patient with ease, he/she may move on to do standing knee bends, assisted knee bends, exercycle, knee exercise with resistance, and pain and swelling exercise.
Frequently Asked Question (FAQs)
Q.1 How painful is a knee replacement?
Ans. Once the knee replacement surgery happens the arthritic pain no longer exists. The pain after surgery arises from wound healing, inflammation and swelling. It has been observed that knee replacement patients experience only a little pain after three months.
Q.2 What is the newest procedure for knee replacement?
Ans. The newest procedure for knee replacement is the minimally-invasive quadriceps-sparing in which a surgeon inserts a similar time-tested knee replacement implant which is reliable through a small incision. The approach used here includes avoiding trauma to the quadriceps muscle which is a vital muscle group present around the knee.
Q.3 What is the new less invasive knee replacement surgery?
Ans. The new less invasive knee replacement surgery consists of a smaller cut or incision unlike in traditional knee replacement. Through this incision, the surgeon accesses the shinbone and thigh bone. He removes a portion of bones that form a part of the knee joint and replaces it with a metal component to recreate the joint. A layer so plastic is inserted between the metal components for smooth gliding.
Q.4 What is the best age for knee replacement surgery?
Ans. There is no best age for knee replacement surgery as this surgery is based on the pain and disability which a patient is going through. However, most patients aged 50 to 80 undergo this surgery.
Q.5 What causes a person to need a knee replacement?
Ans. A knee replacement surgery is needed when a person’s knee is damaged or worn out leading to reduced mobility and pain even during rest. Osteoarthritis is the most common reason for knee replacement surgery; other conditions include rheumatoid arthritis.
Some signs which indicate that you might need knee replacement surgery include persistent knee pain, reduced mobility, and stiffening of knees.
Q.6 How long does it take to recover from a knee replacement?
Ans. It has been observed that the patients who go through a knee replacement surgery resume normal life within 6 weeks and can drive within 3 to 6 weeks. However, it may take 4 to 6 months or maybe an entire year to recover fully.
Q.7 How much does it cost to get a full knee replacement?
Ans. A minimum amount for knee replacement is Rs. 1,50,000 average cost is Rs. 2,20,000 and the maximum cost for knee replacement reaches up to Rs. 3,00,000.