Knee Replacement

Knee joint replacement is a surgery to replace all or part of the knee joint with an artificial man-made joint. The artificial joint is called a prosthesis.

Your knee joints are made up of several major parts and one or more of those parts may be replaced during surgery.

Knee Replacement Surgery Description

Damaged cartilage and bone are removed from the knee joint. Man-made pieces are then placed in the knee.

These pieces may be placed in the following places in the knee joint:

Lower end of the thigh bone — This bone is called the femur. The replacement part is usually made of metal.
Upper end of the shin bone, which is the large bone in your lower leg — This bone is called the tibia. The replacement part is usually made from metal and strong plastic.
Back side of your kneecap — Your kneecap is called the patella. The replacement part is usually made from strong plastic.

Robot-Assisted Total or Partial Knee Replacement using the Mako Surgical System

Mako is an innovative solution for many suffering from painful arthritis of the knee. It all starts with a CT scan so your surgeon can create a 3D CT-based model of your knee. In the operating room, your surgeon follows your personalized surgical plan. The surgeon guides Mako’s robotic arm with precision.

Knee Replacement Surgery Procedure

General Description, please consult with your surgeon about the plan for your procedure.

After you receive anesthesia, your surgeon will make a cut over your knee to open it up. This cut is often 8 to 10 inches (20 to 25 centimeters) long. Then your surgeon will:

• Move your kneecap (patella) out of the way, then cut the ends of your thigh bone and shin (lower leg) bone to fit the replacement part.
• Cut the underside of your kneecap to prepare it for the new pieces that will be attached there.
• Fasten the two parts of the prosthesis to your bones. One part will be attached to the end of your thigh bone and the other part will be attached to your shin bone. The pieces can be attached using bone cement or screws.
• Attach the underside of your kneecap. A special bone cement is used to attach this part.
• Repair your muscles and tendons around the new joint and close the surgical cut.

Most artificial knees have both metal and plastic parts. Some surgeons now use different materials, including metal on metal, ceramic on ceramic, or ceramic on plastic.

Why the Procedure Is Performed

The most common reason to have a knee joint replaced is to relieve severe arthritis pain. Your doctor may recommend knee joint replacement if:

• You are having pain from knee arthritis that keeps you from sleeping or doing normal activities.
• You cannot walk and take care of yourself.
• Your knee pain has not improved with other treatment.
• You understand what surgery and recovery will be like.

Most of the time, knee joint replacement is done in people age 60 and older. Younger people who have a knee joint replaced may put extra stress on the artificial knee and cause it to wear out early and not last as long.

Before the Procedure

Always tell your health care provider what drugs you are taking, even medicine, supplements, or herbs you bought without a prescription.

During the 2 weeks before your surgery:

• Prepare your home.
• You may be asked to stop taking medicines that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), blood thinners such as warfarin (Coumadin), and other medicines.
• You may also need to stop taking medicine that can make you more likely to get an infection. This includes methotrexate, Enbrel, and other medicines that suppress your immune system.
• Ask your provider which medicines you should still take on the day of your surgery.
• If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see the provider who treats you for these conditions.
• Tell your provider if you have been drinking a lot of alcohol, more than 1 or 2 drinks a day.
• If you smoke, you need to stop. Ask your provider or nurse for help. Smoking will slow down wound and bone healing. It has been shown that smokers have worse outcomes after surgery.
• Always let your provider know about any cold, flu, fever, herpes breakout, or other illness you have before your surgery.
• You may want to visit a physical therapist to learn some exercises to do before surgery and to practice using crutches or a walker.
• Set up your home to make everyday tasks easier.
• Ask your provider to see whether you need to go to a nursing home or rehabilitation facility after surgery. If you do, you should check out these places ahead of time and note your preference.

Practice using a cane, walker, crutches, or wheelchair correctly to:

• Get in and out of the shower
• Go up and down stairs
• Sit down to use the toilet and stand up after using the toilet
• Use the shower chair

On the day of your surgery:

• You will usually be asked not to drink or eat anything for 6 to 12 hours before the procedure.
• Take the drugs your provider told you to take with a small sip of water.

Your provider will tell you when to arrive at the hospital.

After the Procedure

You will stay in the hospital for 1 to 2 days. During that time, you will recover from your anesthesia and from the surgery itself. You will be asked to start moving and walking as soon as the first day after surgery.

Some people need to work with a rehabilitation provider after surgery. Newman Regional Health provides both inpatient and outpatient rehabilitation services. During rehab, you will learn how to safely do your daily activities on your own. Home health services are also available.

Outlook (Prognosis)

The results of a total knee replacement are often excellent. The operation relieves pain for most people. Most people do not need help walking after they fully recover.

Most artificial knee joints last 10 to 15 years. Some last as long as 20 years before they loosen and need to be replaced again. Total knee replacements can be replaced again if they get loose or wear out. However, in most cases, the results are not as good as the first time. It is important not to have the surgery too early so you will need another surgery at a young age or have it too late when you will not benefit the most. After surgery, you should have periodic check up with your surgeons to make sure the parts of your artificial joint are in good position and condition.