Total Knee Replacement Protocol

Total knee replacement surgery is a huge undertaking. It is used as a last resort for end-stage osteoarthritis of the knee and for those who have suffered severe trauma to the knee that makes full recovery impossible. It involves complete removal of the knee cap, the cutting and removing of parts of the upper and lower leg bones and insertion of prosthetic replacements. The surgery is tough on the body, and recovery can be painful, but the outcome is often a vast improvement in motion and quality of life. Once the knee is replaced and healing has begun, there is usually significant reduction of pain for the patient, making the operation highly successful.

Types

• There are three types of knee replacement surgery. In minimally invasive total knee replacement, the smallest possible incision is used and much of the work is done with arthroscopic instruments. This is not always possible, but is the chosen method for those who qualify for it. Standard knee replacement involves a 6- to 9-inch incision, depending on the patient and the needs of the surgeon. The third kind is uncommon, and is called compartmental replacement surgery. This is when only a part of the knee is replaced. The diseased part is removed and a prosthetic put in, but the healthy part of the knee is left intact.

Effects

• The effects of knee replacement are almost instant. Patients who have had a total knee replacement are up and fully weight bearing within 24 hours. Amazingly enough, pain is often reduced from what was suffered pre-op, as the patient has been enduring tremendous bone-on-bone pain for a long period of time leading up to the surgery. Although it does take extensive physical therapy and rehab to regain muscle tone and full use of the leg, the effects of knee replacement surgery are quite dramatic. Patients who could barely walk without pain will experience a huge improvement in their lives. Walking, climbing, kneeling and other daily activities that may have been impossible for them before the surgery will be theirs once they have completed their recovery. The only thing that is not allowed is running and jumping.

Considerations

• Things to consider when contemplating knee replacement surgery are age, health and activity of the patient. Age can be tricky. Knee replacements can usually only be done twice on the same knee in a lifetime, so if one is done while a patient is young, it does not bode well for them if they live to be elderly. Knee replacements are generally made for older patients who are not as active and hard on their bodies as younger patients. A knee replacement that might last 15 years on an elderly person may only last half of that on a person in the middle of their lives. Before a knee replacement is done on a person younger than 50, all other options should be exhausted.

Benefits

• The benefits of replacement knee surgery are huge for those who have needed one. Osteoarthritis is the degeneration of cartilage and bone, and patients who are in the end stage of this disease in their knees are often enduring a tremendous amount of pain on a day-to-day basis. Once this diseased joint has been replaced with a prosthetic that allows the limb to function as intended, the change is tremendous. Patients can walk, climb, kneel and do daily activities without the pain and limited flexibility they had endured before the surgery. For those who have come to the point of needing a replacement, this surgery can be a lifesaver.

Warning

• The surgery is not to be taken lightly. Although it is tremendously beneficial, it also has risks. The shock to the body of having large pieces of bone cut and removed, the blood loss, the pain of the surgery and the trauma to the body during the actual surgery can be quite dangerous, especially if the patient is not in good health or is frail. As with any major surgery, there are dangers from infection and from the drugs that are needed to control pain post-op. All these things should be taken into consideration before committing to the knee replacement surgery.

Time Frame

• The typical time frame from the time of the actual surgery until release from physical therapy is usually 6 months. Physical therapy will begun immediately post-op and is the most critical step in the recovery process. Visits will usually start at twice a week, then ramp up to three or more times a week, then taper off to twice, then once a week, then every other week and finally once a month until released. Dedication to their recovery and absolute commitment to the rehab will mark a fast healing and a return to normal life. An actual time frame is impossible, as it will vary from patient to patient.