Joint Replacement Surgery
What is a Joint Replacement Surgery?
Arthritis of the joints can result in pain and functional difficulty. In some severe cases, patients are unable to walk even short distances. Often, medication, injections, and joint cleaning procedures such as arthroscopy do not provide optimal function or adequate pain relief. Joint Replacement surgery has become the standard of care for this group of conditions.
Why is total joint replacement necessary?
The goal is to relieve the pain in the joint caused by the damage done to the cartilage. The pain may be so severe, a person will avoid using the joint, weakening the muscles around the joint and making it even more difficult to move the joint.
A physical examination, possibly some laboratory tests and x-rays will show the extent of damage to the joint. Total joint replacement should be considered if other treatment options will not relieve your pain and disability.
How is a total knee joint replacement performed?
You will be given an anesthetic and the surgeon will replace the damaged parts of the joint. In an arthritic knee, the damaged ends of the bones and cartilage are replaced with metal and plastic surfaces that are shaped to restore knee movement and function.
The materials used in a total joint replacement are designed to enable the joint to move just like your normal joint. The prosthesis is generally composed of two parts: a metal piece that fits closely into a matching sturdy plastic piece. Several metals are used, including stainless steel, alloys of cobalt and chrome, and titanium. The plastic material is durable and wear-resistant (polyethylene).
Our knee specialist Dr Sean Leo is well-versed in the latest techniques in joint replacement surgery, including Computer-aided Navigation, Minimally-invasive Surgery (MIS) and partial joint replacements like Unicondylar Knee Replacements (“Uni”) and Hip Resurfacing operations. In MIS, specially designed jigs are used to guide the insertion of the hip and knee joint replacement parts. The result is a smaller incision which may be less painful and may allow an earlier return to walking. Normal Hip and Knee Replacement scars can be about twenty centimeters long, MIS techniques allow the scar to be less than ten centimeters
Unicondylar Knee Replacement
If your condition is not very severe, you might be a candidate for a “half knee”. This is known as a Unicondylar knee replacement. The recovery for this operation is faster than for a Total Knee Replacement but it is only suitable for patients with milder symptoms. These are patients with knee arthritis in which only half the joint is involved. This does not occur as often as when the whole joint is involved, but when indicated, allows for a smaller incision and earlier return to function. The figure on the right shows a “Uni” knee in position.
What happens after total knee joint replacement surgery?
You will likely stay in the hospital for a few days after surgery. During this time:
The surgical incision will be monitored for signs of infection or complication.
Pain will be managed around the clock using medications and ice therapy.
A nurse and physical therapist will work with you to begin knee exercises and help you move from bed to chair.
You will practice walking with assists like a walker or brace
An intravenous catheter (IV) will deliver fluids and medications.
Once discharged, you’ll continue physical therapy either at home or outpatient:
Physical therapy typically starts 1-3 times per week for 4-6 weeks, focusing on range of motion and strengthening exercises.
Over time, you’ll graduate from a walker to cane and then walk unassisted. Stairs may take 4-6 weeks.
It may take 3-6 months post-op to regain full function and strength in your new knee. Rehabilitation is key.
Swelling and pain should gradually improve over the first few months.
You will be scheduled for follow-up with your orthopaedic surgeon at 2 weeks, 6 weeks, 3 months and 6 months typically.
Return to activity can take some time. While the timeline for recovery differs depending on the patient’s condition and the commitment to physical therapy, most patients can return to light activities within 4-6 weeks.
Driving may take 4-6 weeks once off pain meds.
Low-impact exercises like cycling and swimming typically at 2-3 months.
Return to more intense activities like golf and tennis requires around 4-6 months of rehab and strength gains.
Full recovery may take up to 1 year but most see significant improvement by 6 months.
Overall, total knee recovery requires dedication to physical therapy, gradual progression of activities and patience to allow time for healing. But, with adherence to the post-op regimen, most patients go on to experience improvement in knee pain, mobility, and quality of life after a total knee replacement.
Wondering if a joint replacement is the right choice for your knee condition? Book an appointment with our knee specialist Dr Sean to find out more in a consultation.
