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Reproduced
with permission from Your Orthopaedic Connection. ©American
Academy of Orthopaedic Surgeons. |
Knee replacement is a procedure that is done for the severely arthritic joint, and only after other forms of treatment, such as medication and physical therapy, no longer have any benefit.
Knee with arthritis
Cartilage is the material that cushions the knee and allows the joint to move in a smooth and free manner. As the cartilage wears out, arthritis develops as the bone ends rub against each other and cause pain. As the joint becomes more damaged and painful, it may be time to consider surgical replacement.
The surgical procedure
The surgical procedure involves removing the diseased portions of the joint and replacing them with new parts. The arthritic surface of the femur (thighbone) is removed and replaced with a metal femoral implant. Similarly, the arthritic surface of the tibia (shinbone) is removed and replaced with a metal tibial implant. The underside of the patella (knee cap) is cut and replaced with a plastic implant. These three implants are cemented onto their respective bones. Another plastic implant is placed between the metal femoral and tibial components to allow the knee to bend and straighten painlessly.
The surgical procedure usually takes one to two hours, and the new joint is stable right away, allowing patients to walk immediately after their surgery. Physical therapy is necessary to achieve full bending and straightening so the joint does not become stiff.
Anesthesia
This procedure can be done under general anesthesia (the patient is asleep with a breathing tube) or spinal anesthesia (an injection into the back that numbs the patient from the waist down). That decision is made by the patient and anesthesiologist.
Hospital stay
Before surgery
Patients are admitted to the hospital the day of surgery. Prior to surgery, they will meet the anesthesiologist and talk to the surgeon.
After surgery
Patients can begin walking and bending the knee immediately without restrictions. There may be pain initially, which will improve, and this can be controlled with medications. Most patients will stay about two nights in the hospital, although some will leave sooner or later depending on their mobility and home situation.
Social services
Mid Coast Hospital's care coordinators will work with the patient to ensure that the transition from the hospital to home is as seamless as possible.
Most patients will go directly home from the hospital, but some will go to a rehabilitation facility temporarily. The decision to go to a rehab facility or directly home is made by the patient, but the orthopedic care team will make recommendations based on the progress that a patient makes in the first few days after surgery. Learn about Mid Coast Senior Health Center and CHANS Home Health & Hospice as an option for rehab care.
Patient involvement and commitment
With knee replacement, the surgeon replaces the diseased knee joint and, along with the physical therapist, occupational therapist and nursing staff, guides the patient through the recovery process. However, rehabilitation is up to the patient. The patient must participate fully in the rebuilding and strengthening of weakened muscles. To get the total benefit of knee replacement, the patient must make a serious commitment to doing the prescribed exercises and developing and maintaining an active lifestyle. Learn about Mid Coast Hospital Outpatient Rehabilitation.