When for years you haven’t been able to bend down to tie your shoelaces, or adjust the backstrap of stylish sandals, or walk up or down stairs without assistance, you are a ripe candidate for total knee replacement surgery (TKRS). However, just because your knee pains intolerably is insufficient reason to undergo TKRS.
Ask yourself whether your daily activities are getting impaired, or whether the aching knee is substantially diminishing the quality of your life, or hindering your professional commitments. You should have also explored the option of rehabilitation physiotherapy, or physical therapy as it is sometimes called. Check with your doctor whether your arthritis is so far advanced as to require total knee replacement. Your age is another factor which your doctor will consider.
You think several times before throwing out articles from your household or office. A part of your body is more intrinsic to your existence. Therefore, you must check out how far that swelling in your knee which refuses to go away, and consequent pain is resistant to every kind of treatment. If steroid injections, other medications, fomentations, and massage are not giving any measurable relief for arthritic pain; you should ask your doctor about all the aspects of knee replacement surgery, including the downside. If the level of pain is preventing you from getting adequate sleep and is interfering with your ability to think clearly; then knee replacement surgery is certainly for you.
Other conditions which could be causing you intolerable distress: Though degenerative diseases like rheumatic arthritis and osteoporosis (bones losing their density) are prime reasons for doctors electing to replace knees; gout, post-traumatic arthritis, and damaged or diseased cartilage and bones are also major causes for creating conditions where the doctor needs to consider TKRS.
As with all major surgery, there are some precautions to follow. Since you are getting an artificial joint made of metal and plastic to replace a natural one made of bones, cartilage, and ligaments, your doctor will always look at options to keep it minimally invasive. Therefore, if your knee is not too damaged, then a partial replacement with a smaller incision would be made. The main purpose is to restore motion to the joint, with pain reduction being a secondary consideration
Your orthopedist might recommend weight loss through diet control, physical therapy, and even weight loss surgery prior to TKRS, if you are overweight or obese, to ensure swifter recovery.
To ensure replacement without glitches, precise measurements are taken of your knee. The metal and plastic parts are placed after removal of all damaged parts of your knee. Where necessary, the kneecap is also removed, if the knee has been crushed in an accident.
Depending on your overall health and age, the anesthesiologist might opt for epidural anesthesia which will keep you awake, but with no sensation below the waist, instead of general anesthesia (GA). Certain conditions make putting a patient on GA a dicey proposition. Since the preferred age for knee replacement is 60 or more years of age, it is a valid concern.
Most people are delighted to be able to move around without assistance after the convalescence period. While you won’t be able to compete in the high jump or the pole vault events; you will be able to walk to the corner store, move around the house without suffering agonies of pain, negotiate easy stairs comfortably, cook, and maybe tie your own bootlaces. After six months or so, you might even be back in the driver’s seat literally.
As in any major operation, there are some inherent dangers which might occur, even if rarely. There is a definite risk of infection, especially deep-seated infection requiring another operation; blood clotting leading to deep vein thrombosis (DVT), or bleeding from the incision point; complications arising from anesthesia, especially if you are allergic to eggs; aggravation of pain due to the incision and subsequent stitching; and instability or stiffness of the new knee requiring further corrective surgery.
Though TKRS has among the highest success rates among all surgical procedures; recovery time will vary from person to person. Your overall health, how active you were before your knee began troubling you, your natural resilience, and your will power will affect how fast you recover.
Since you will be in the hospital for only a few days, you must prepare for convalescence at home. If there are family members or very close friends who can provide the necessary care and nursing; so much the better. Otherwise, you will need to make arrangements to ensure that the home runs smoothly with minimal effort. You must rest adequately. Also, the painkillers you are prescribed might leave you somewhat addled.
Since the muscles of your legs and back will need to be retrained, you must get physiotherapy to get regain mobility faster. Just keep in mind that with rehabilitative physiotherapy more is not better. You must not overtire your muscles.
Artificial limbs and joints wear out faster than natural ones. If you had to undergo replacement surgery when you were in your forties; the knee will have to be replaced in your seventies. The second procedure takes longer and is more complicated. However, replacing it before the knee becomes completely stiff has displayed better outcomes.