What Is a Knee Replacement?

A knee replacement, or arthroplasty, is a surgical procedure in which the damaged parts of the knee joint are removed and replaced with artificial components called prostheses. The goal of the surgery is to relieve pain, improve knee function, and increase mobility, ultimately improving the patient’s quality of life.

Who Should Have Knee Replacement Surgery?

Candidates for knee replacement surgery are typically people who experience significant knee joint damage that causes persistent pain and interferes with daily activities, despite other treatments. The most common conditions leading to knee replacement surgery include:

• Osteoarthritis (the leading cause of knee joint damage)
• Rheumatoid arthritis (an autoimmune condition causing joint pain and stiffness)
• Osteonecrosis (avascular necrosis) (bone death due to inadequate blood supply)
• Injury (such as old ACL tears, meniscal tears, or fractures)

In the past, knee replacement surgery was generally reserved for older adults, but newer trends show that knee replacements are increasingly being performed in younger patients as well. While surgery can be effective, it should be delayed as long as possible, particularly if the patient is under 55 years of age.

In addition to age, a person’s overall health and activity level are critical factors in predicting the success of knee replacement surgery. People with chronic conditions (such as Parkinson’s disease) or those with muscle weakness may face more difficulty recovering from surgery. Additionally, individuals at high risk for infections or those in poor health may not be ideal candidates for this procedure.

Why Do People Have Knee Replacement Surgery?

For the majority of patients, knee replacement surgery provides significant benefits, including:

• Pain relief: A reduction in chronic knee pain, especially during routine activities.
• Increased mobility: Greater range of motion and ease of movement.
• Improved activities of daily living: Enhanced ability to carry out everyday tasks with less discomfort.
• Better quality of life: A substantial improvement in overall well-being and independence.

What Are Alternatives to Knee Replacement Surgery?

Before opting for knee replacement surgery, other conservative treatments may be explored, including:

• Exercise programs: Strengthening the muscles around the knee joint can improve pain and function. Physical therapy is often the most effective way to manage symptoms.
• Walking aids: Using canes or walkers can reduce the stress on painful, damaged knees and help delay surgery.
• Medication: Pain relievers, anti-inflammatories, and other medications can provide temporary relief.
• Alternative surgeries: Procedures like arthroscopy, high tibial osteotomy (HTO), and unicompartmental knee replacement may be considered depending on the patient’s condition.

What Are Possible Complications of Knee Replacement Surgery?

Thanks to advances in surgical techniques and technology, the risks associated with knee replacement surgery have decreased significantly. However, like any surgery, knee replacement carries potential complications, including:

• Infection: Though rare, infections can occur, requiring treatment or additional surgery.
• Blood clots: Swelling, redness, or tenderness in the calf, thigh, ankle, or foot could indicate a blood clot. Early mobilization post-surgery helps reduce this risk.
• Nerve or vascular injury: Nerve or blood vessel damage can occur, though it is uncommon.
• Implant failure: In some cases, the artificial knee may loosen, leading to instability or pain.

It’s essential to be vigilant about monitoring for symptoms of complications, such as:

• Infection: Fever, chills, increased pain, or drainage from the wound.
• Blood clots: Swelling, warmth, or redness in the leg.

If you notice any of these signs, contact your doctor immediately. Never start antibiotics without consulting your surgeon first.

When Is Revision Surgery Necessary?

While knee replacement surgery is highly successful, it may need to be repeated after 15 to 20 years due to the wear and tear of the implant, especially in younger, more active patients. Revision surgery is a more complex procedure and has a generally lower success rate than the initial surgery.

Common reasons for revision surgery include:

• Instability, pain, or stiffness that doesn’t improve with treatment.
• Bone loss or joint loosening detected through X-rays.
• Fractures or infection around the implant.

What Types of Exercise Are Most Suitable for Someone With a Total Knee Replacement?

Exercise plays a critical role in recovery, helping to reduce stiffness and improve strength and flexibility. Initially, your doctor or physical therapist will recommend low-impact exercises, including:

• Range-of-motion exercises to improve flexibility.
• Strengthening exercises for the muscles surrounding the knee joint.

As you progress, high-impact activities like football or jogging should be avoided, as these can damage the new knee or cause loosening of its parts. Recommended activities include:

• Walking: A low-impact exercise to improve mobility.
• Cycling: Great for building strength without stressing the knee.
• Swimming: Offers a full-body workout while being gentle on the joint.
• Tennis (doubles): A moderate-impact sport that can be done on a soft court.
• Golf: A low-impact option that is generally safe for those with knee replacements.

Exercise should always be done under the guidance of your doctor or physical therapist to ensure safe and effective recovery.