Total Knee Replacement: Should I have surgery?

Why should I have a total knee replacement? How long will it last? How do I know when I should have my knee replaced? What other options do I have? These are viable questions and concerns from most all knee patients who are suffering with pain from degeneration and arthritis that limit their daily function.

First, before deciding on a TKR, one should consider all conservative options. These conservative options should be discussed with your physician. Some of these options may include anti-inflammatory medications, joint injections such as steroid or Viscosupplementation injections (made from the comb of a rooster called Synvisc) which lubricates and cushions joints, physical therapy for range of motion and strengthening exercises and bracing to help unload the joint.

What happens when conservative treatments fail? No one enjoys thinking about undergoing a major surgery such as joint replacement, but when knee pain and disability persist and conservative treatments no longer allow functional mobility and hinder quality of life, TKR should then be considered. The most common diagnosis for TKR is osteoarthritis with the loss of functional mobility, independence, and quality of life. Other diagnoses that lead to joint failure include rheumatoid arthritis, post-traumatic arthritis, bone loss, false gout, and severe patellafemoral arthritis (arthritis under the knee cap).

During surgery the medial and lateral menisci (cartilage) are removed along with any arthritis or joint contractures in the knee. Corrections will be made to any deformities noted in the joint and the patella will either be replaced or resurfaced for correct tracking and pain reduction.

Post-operative complications, as with any major surgery, can include deep vein thrombosis (clots), infection, scarring of the joint tissues, and knee instability. Some of these problems can be diagnosed using equipment like a portable ultrasound machine (and you can find more info here about that particular device), treated quickly, and then recovery can begin. The medical team and rehabilitation team with assistance of family members are crucial in their role to facilitate a safe, effective, and successful restoration of function. Weight bearing, mobility, and ROM are highly encouraged in early recovery as well as monitoring of blood clotting levels and occasionally home therapy range of motion assistance using a CPM (continuous passive motion) machine.

Knee implants function well 10-15 years with 76.4% of all implant components still surviving at 20 years (Ritter & Meneghini, 2010). More than 85% of patients will achieve good success from their TKR when engaged in a good post-surgical rehab program to improve strength, range of motion, and mobility (Williams et al., 2010).

Physical therapy can be a great way to prepare for your knee replacement to gain as much motion and strength prior to your surgery. This typically leads to a better and quicker recovery following surgery. Therapy will also be a necessity following your surgery to regain motion and strength to be able to return to your normal daily activities.

If you are having pain in your knee or have a total knee replacement scheduled, please come see us for a free consultation to see how we can assist you in your recovery. To request an appointment, click here, or call directly to one of our three locations during regular business hours:

Cool Springs: 615-224-9810
Shelbyville: 931-684-0027
Spring Hill: 931-489-2022

Disclaimer: The information in this blog is intended to be informational only, and is not intended to be used in lieu of medical care. Consult a doctor or a physical therapist before attempting treatment on your own.

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