11 Common Knee Replacement Surgery Questions and Answers

If a doctor has told you that you need a knee replacement, you probably have a lot of questions about what to expect. This article tells you everything you need to know before surgery.

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There’s no precise formula for deciding when to have a knee replacement. The main reason to have it done is pain. If you’ve tried other options, including lifestyle strategies, anti-inflammatory medication, physical therapy, and injections, it may be time to think about surgery.

An orthopedic surgeon will perform a thorough examination and make a recommendation. You might also want to get a second opinion.

5 reasons to consider knee replacement surgery

Before you consider surgery, your doctor will usually encourage you to try various nonsurgical treatments, which may include:

• physical therapy
• weight loss (if appropriate)
• anti-inflammatory medication
• steroid injections
• hyaluronic (gel) injections
• alternative treatments such as acupuncture

In some cases, these solutions may help manage knee problems. But if the symptoms worsen and start to affect your quality of life, surgery may be the best option. Delaying or avoiding surgery for a long time can make things worse.

Ask yourself questions such as:

• Have I tried everything?
• Is my knee preventing me from doing the things I enjoy?
• Will a knee replacement improve my quality of life?

Get more information to help you determine whether you should consider knee surgery.

The surgeon makes an incision over the front of your knee to expose the damaged area of your joint. They move your kneecap to the side and cut away the damaged cartilage and a small amount of bone.

Then, they replace the damaged tissue with new metal and plastic components. The components combine to form an artificial joint that is biologically compatible and mimics the movement of your natural knee.

Most knee replacement procedures take 1 to 2 hours to complete.

Artificial knee implants consist of metal and medical-grade plastic called polyethylene.

There are two ways of attaching the components to the bone. One is to use bone cement, which usually takes about 10 minutes to set. The other is a cement-free approach, which involves components that have a porous coating to allow the bone to grow onto them.

In some cases, a surgeon may use both techniques during the same operation.

Any operation that involves anesthesia has risks, but severe complications are rare.

If you’re having a total knee replacement, your options are:

• general anesthesia
• spinal or epidural anesthesia
• a regional nerve block

An anesthesia team will decide on the most suitable options for you, but most knee replacement procedures involve a combination of the above methods.

You’ll definitely experience some pain after your operation, but your surgical team will do everything possible to keep it manageable and minimal.

You might receive a nerve block before your operation, and your surgeon might use a long-acting local anesthetic during the procedure to help with pain relief after the procedure. Your doctor will also prescribe pain medication.

Once you recover from surgery, your knee should be significantly less painful than it was before. However, there is no way to predict the exact results, and some people continue to have knee pain for many months after the operation.

Find out more about the medications you may need after surgery.

If you received a general anesthetic, you might wake up feeling a bit confused and drowsy. You’ll probably wake up with your knee raised (elevated) to help with swelling.

To reduce your risk of developing a blood clot, you may need anticoagulant medication (blood thinners), foot/calf pumps, or both.

Many people have an upset stomach after surgery. This isn’t anything to worry about, and your healthcare team may provide medication to ease the discomfort.

Your doctor will also prescribe intravenous (IV) antibiotics to reduce your risk of infection. Antibiotics can help prevent infections, but it’s important to be able to recognize the signs of an infection in case one occurs after knee surgery.

Most people are up and walking within 24 hours with the help of a walker or crutches.

After your operation, a physical therapist will help you bend and straighten your knee, get out of bed, and ultimately learn to walk with your new knee. This often happens on the same day as your operation.

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Most people are discharged from the hospital the same day or the morning after surgery.

Once you return home, you’ll continue to have therapy regularly for several weeks. You’ll perform specific exercises that aim to improve the functionality of the knee.

If your condition requires it, or if you don’t have the support you need at home, your doctor might recommend that you spend time at a rehabilitation or nursing facility first.

Most people recover within 3 months, although it may take 6 months or longer for some people to recover fully.

If you live in a multiple-story house, prepare a bed and space on the first floor so you can avoid the stairs when you first come home, if possible.

Make sure your home is free of obstructions and hazards, including power cords, area rugs, clutter, and unnecessary furniture. Focus on pathways, hallways, and other places you are likely to walk through.

• handrails are secure
• a grab bar is installed in the tub or shower
• a bath or shower seat is available

According to a research review, more than 82% of total knee replacements are still functioning 25 years later. But wear and tear can negatively affect the performance and life span of an artificial knee.

Younger people are more likely to need another knee surgery at some point in their lifetime, mainly as a result of having a more active lifestyle. You can consult a doctor about your specific situation.

Author: Joshua Steere, MD​

Why does my knee click or pop?

Knees can make noise from time to time, especially knees with osteoarthritis. This can be from a variety of causes, most of which are not cause for alarm. In knees with osteoarthritis, the smooth cartilage surface on the end of the bone wears down and becomes damaged, making the ends of the bones uneven and rough. When the knee bends and straightens, these rough surfaces move past each other and can make a clicking or snapping sound. Osteoarthritis can also cause the lining of the knee joint to become thickened and inflamed. This is called synovitis. Sometimes clicking or snapping can be caused by this thickened synovium rubbing over the edges of the bones and knee cap. Concerning symptoms would be popping that leads to a significant amount of painful swelling or instances where the knee locks up and cannot be bent or straightened. These symptoms should be evaluated by your doctor.

Why is my knee swollen?

Many people with knee osteoarthritis will feel the knee swell from time to time. The knee joint normally contains a small amount of fluid called synovial fluid which helps lubricate the knee as it moves and provides nutrients to the cartilage. Knees with osteoarthritis, however, often make extra synovial fluid that can cause the knee to fill up and feel swollen and tight. After periods of increased activity, the swelling may increase if the knee is aggravated and painful. Sometimes the synovial lining of the joint can also become thickened and inflamed, causing the knee to feel puffy. Helpful treatments for knee swelling are compression stockings, ice, elevation, rest, and anti-inflammatory medications. Knee swelling can also be caused by other conditions such as traumatic injury, infection, or gout. Talk to your doctor if you have abnormal knee swelling.

What is a Baker’s cyst?

A Baker’s cyst (also known as a popliteal cyst) is common in knees with osteoarthritis. If the knee has extra fluid from inflammation, that fluid can pool up in the back of the knee. When that fluid pools up, it can cause an outpouching of the joint capsule in the back of the knee. This outpouching is referred to as a Baker’s cyst. Though a Baker’s cyst is not dangerous, it can get larger or smaller depending how much fluid is in the knee. It can be uncomfortable and make the back of the knee feel tight. Draining the fluid is not routinely recommended because the fluid in the knee joint often flows back into the area. Treating the underlying osteoarthritis is often the best way to treat a Baker’s Cyst. This can reduce the inflammation and swelling that causes discomfort in the back of the knee.

Why does my knee give out?

Knees with painful osteoarthritis can sometimes feel like they give out or buckle. This is often caused by an involuntary response to pain where the quadriceps muscle becomes weak. The quadriceps muscle is in the front of the thigh. It attaches to the kneecap and helps keep the knee straight when walking. Just as the body will involuntarily pull the hand away from a hot surface, the body sometimes responds to pain in the knee by involuntarily making the quadriceps muscle give out. When this happens, the knee can feel unstable. This can be dangerous if it happens going down stairs or if it causes loss of balance. If this happens often, using an assistive device like a cane, crutches, or a walker can help prevent injury. Often these buckling episodes can be improved with pain control, reducing the inflammation in the knee, and strengthening the muscles around the knee with low impact exercise and/or physical therapy. The knee can also give out due to instability from a ligament injury or tendon injury, so consult with your doctor if the knee feels unstable or if you have had an injury.

If you are struggling with knee pain, please call (215) 348- to schedule a consultation with one of our specialists.

These are other useful links for knee osteoarthritis:

American Academy of Orthopaedic Surgeons (AAOS) – Clinical Practice Guidelines on Treatment of Osteoarthritis of the Knee

http://www.orthoguidelines.org/topic?id=

American Association of Hip and Knee Surgeons (AAHKS) – Patient Care Library

https://hipknee.aahks.org/relieving-hip-and-knee-pain-without-surgery/

American College of Rheumatology / Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee.

https://www.rheumatology.org/Practice-Quality/Clinical-Support/Clinical-Practice-Guidelines/Osteoarthritis

US Department of Health and Human Services – Physical Activity Guidelines for Americans

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