Things to Know About Total Knee Replacement

Knee Replacement: Things you must know.

In knee replacement surgery, surgeons cut away damaged bone, cartilage, and a ligament or two and add an artificial joint made of metal and plastic. For people who we suffered years of pain and limited mobility not being able to climb stairs or bend down to tie their shoes a brand-new knee can be life-changing. People come in crippled; they cant even go from the waiting room to the operating room unassisted and after surgery when they walk out of the hospital two days later. Its amazing.

But here are few things one needs to know before taking the dip, as lack of information or surprise may turn the immediate post op experience sour.

• Right Timing and correct indication: Total Knee Surgery is indicated only for advanced Degeneration of knee and not for early symptoms / mild osteoarthritis. Before planning for total knee replacement one has to be sure that the pain is localized primarily to knee joint and not arising from spine or hip joint; and all the conservative measures (medicine / physical therapy) have failed to relieve the pain effectively.
• Post Operative Pain It does hurt: Knee does pain for variable time after the surgery. The pain is worse in initial few days, but fortunately can be treated well with modern day analgesia techniques including epidural infusions, Intravenous drugs, Nerve Block, Transdermal Patch and oral drugs. Some pain persists for 2 months duration, but keeps improving everyday with Physiotherapy, Icing and Mild oral analgesics. Numbness or tingling on outer aspect of the knee may take few months to disappear.
• Swollen Knee: Knee swelling is a common thing to see in the postoperative period after total knee replacement, and remains so for up to two months. The swelling reduces significantly in the first week and then gradually over time. Icing frequently helps to reduce swelling
• Go Gentle; Tougher Physiotherapy may not always be better: Physiotherapy is very important in the postoperative period to increase strength, Range of motion and improve function. But we recommend balancing rest with activity. Tougher Physiotherapy, forceful exercises and exponential targets for walking may increase pain and swelling. Start with gentle exercises and necessary walking and keep on increasing the exercises in time and intensity as per individual tolerance.
• Icing :Icing is a very important tool for reducing swelling and inflammation in the operated knee. A good ice pack, which wraps around the knee, applied multiple times during day on a straight knee really helps.
• Too many Drugs: You might experience nausea or diarrhea during the postoperative period because of the number and type of medications you are on. Similarly, analgesic medications may make you feel sleepy or dizzy. Careful attention to the medical treatment and individualization of drug therapy helps in reducing the uncomfortable effects of the drugs.
• Pain in the Back of knee and Ankle or Back Pain: Bow-legs, knock knees or limp disturbs the normal walking pattern. After Knee replacement the knee alignment is corrected and the patients start walking, patients may complain of pain in ankles, back or even radiating pain in legs because of spine degeneration. These symptoms usually improve with time or with physical therapy
• We are changing knee and not reversing the age: The goal of knee replacement is to relieve pain and restore function and in no way it can make you young. Breathlessness while walking or limited walking without knee pain may be due to cardiac or respiratory issues and need to be addressed separately.
• Prepare yourself: A motivated and aware patient improves better than an unprepared one. Patients with good muscle strength and coordination improve better than patients with weak muscles and patients who are not actively walking for long time.
• Medical problems may limit the benefits of knee surgery: Patients have to be aware that medical problems especially neurological conditions like Parkinson’s disease, ataxia etc. affect the final outcome after surgery. Knee Surgery may be able to relieve pain, but walking ability may not improve significantly after the surgery because of these neurological diseases. This will depend on the severity and level of control of the neurological disease.