Knee Replacement Surgery & Pain Control

Knee replacement is easily one of the largest, most complicated orthopedic surgeries a patient can have. It is major surgery, involving the removal of bone, the placement of man-made prosthetic devices and extensive physical therapy. Patients can look forward to a much-improved quality of life, in most cases, but will be forced to endure a lot of physical pain during their recovery. This article will give you some of the basics of the surgery and options for pain control.

Knee Replacement Surgery

• In knee replacement surgery, the lower part of the femur, the upper part of the tibia and the entire knee cap (patella) are removed and replaced with a man-made prosthetic. This is the last option for treatment of severe osteoarthritis, in which the cartilage covering the bones has worn away and bone is rubbing on bone, causing severe pain and swelling, plus internal bleeding and bone damage. Sometimes, in the case of trauma or other injury, knee replacement is the best option for a patient, who can still retain mobility in the knee.

The Surgery Itself

• The surgery takes from 90 minutes to 3 hours or longer, if more extensive work needs to be done. The patient is put under general anesthesia and blood is available in case a transfusion is necessary. An incision of 4 to 8 inches is made, depending on the needs of the surgeon and the extent of the damage or operative history of the patient. The surgeon removes sections of the leg bone and the patella, replaces them with prosthetics and closes the incision after reattaching muscles, tendons and sinew. The patient is brought out of anesthesia, and taken to recovery. A hospital stay of three days is normal, longer if the patient is older or needs additional therapy to make it home.

Pain and Medication

• As with any major surgery, the pain from knee replacement surgery can be quite severe. Without question, the shock to the body of having bone sawed and removed, as well as having foreign objects inserted, and the complete rearrangement of bone and sinew, is tremendous. The patient must be carefully monitored in recovery to make sure shock is not severe, and that pain is controlled. A morphine pump is installed in the patient's I.V. and can be used at controlled intervals to numb the pain. The I.V. is removed as soon as possible, because recovery is dependent on the patient getting up and moving, and heavy narcotics make that impossible. Once the morphine is removed, other oral narcotics are used to control the pain.

Physical Therapy

• Patients need to realize it will take time to recover from knee replacement surgery. There will be extensive physical therapy, and pain control will continue for many months. Addictive substances must be weaned off as soon as possible, but it is important to realize there will be good days and bad days. Constant pain medication won't be needed as time progresses. Pain medication should be taken as needed. Eventually, over-the-counter medication will suffice.