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Should I Consider Knee Replacement Surgery?
You may want to consider knee replacement surgery if you have:
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There are many conservative treatment options. Consider joint replacement if you have failed:
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Most knee replacements are performed on patients between 50-80 years old. If you can wait until you are in your 60’s or 70’s, there is a good chance the surgery will last your lifetime. However, there is no “magic age” to have a replacement. Some people do not feel they can wait any longer, due to loss of quality of life, and may proceed at a younger age, understanding they may require a revision surgery in the future. The decision to proceed should be made after in-depth discussions with your surgeon and a thorough understanding of the procedure and its risks.
What Does it Actually Mean to Have a Knee Replacement?
A TKA (total knee arthroplasty) and a TKR (total knee replacement) are the same thing. In a “total,” all the worn cartilage surfaces are removed with a saw (about one centimeter thick cuts) and similar thickness metal implants are used to cap the remaining bone. There are high quality plastic liners that separate the metal implants. You keep many aspects of your native knee including the joint capsule tissue, quadriceps tendon, patellar tendon and patella, the medial and lateral collateral ligaments and often the posterior cruciate ligament. The remaining meniscus and the anterior cruciate ligament (ACL) are removed, but the knee is stabilized by other functions of the implant. The cartilage surface of the patella may be left alone or resurfaced with a plastic implant depending on the individual situation. Once the procedure is performed you cannot go back to your native knee, as key tissues have been removed.
How Long is Recovery From a Knee Replacement?
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The most critical period of recovery occurs during the first 3 months, when you are working hard to decrease pain and swelling, improve range of motion and wake up the muscles around the knee using physical therapy, home exercises and often a stationary bicycle.
Most people are able to return to work within a month, if their job does not require them to stand all day or lift, push or pull heavy objects. The majority of patients continue to take over the counter medications (Tylenol and anti -inflammatories) and ice daily for several months. Some patients are able to return to activities such as light hiking after just a few months.
There will be days and nights during those first few months that you will wish you had not had the surgery, but in the end, most people comment they wonder why they waited so long. You may continue to see improvements for 1-2 years after surgery as you regain overall strength and endurance.
Can I Have a Partial Knee Replacement Instead of a Total?
There are three compartments in the knee: medial, lateral and patellofemoral. Each compartment can be replaced independently of the others (Unicompartmental knee replacement), but ONLY IF the other compartments are not showing any signs of cartilage wear or contributing to your pain, and the alignment and range of motion are near normal.
Replacing one compartment may not prevent progression of arthritis in the other two compartments, and a partial knee replacement may have to be revised (a second major surgery removing the old implants and placing new implants) to a total knee replacement down the road. If a partial replacement is done in an appropriate patient it may last more than a decade. Partial knee replacement may be a good option for a younger patient with post-traumatic arthritis in one compartment or an older patient with osteoarthritis wear in only one compartment. It may “feel” more like your natural joint, as the ligaments in the center of your knee are retained. These surgeries may be done with the assistance of a robot. Our surgeons are trained to use the MAKO robotic knee replacement system, as well as the standard technique using cutting jigs.
To set up an appointment for further evaluation, please call (208) 336-8250.