Knee Replacement Surgery

Get back in the swing of life with knee replacement

Knee pain disrupts everyday life. You want to be able to climb stairs, move around and do fun things without constant pain. Many people who have knee replacement surgery say that they wish they’d done it sooner.

Knee replacement is an elective procedure that restores function of the knee joint and relieves pain. Every year, more than one million Americans, including many right here in Indiana, return to their lives pain free, due to total joint replacement surgery.

You should consider a knee replacement if you've noticed increased knee pain, progressive limping, or pain that wakes you up at night. These kinds of changes indicate that knee replacement could be an option to minimize debilitating knee pain.

Who Benefits from Total Knee Replacement

People who experience the most dramatic benefits from total knee replacement are those experiencing knee pain due to:

Many people have chosen to have knee replacement surgery so they can do the things they love without pain.

Why Choose IU Health for Your Knee Replacement

Thanks to our relationship with Indiana University School of Medicine, one of the most prestigious medical schools in the country, you receive the latest treatments and benefits of research and experience. Orthopedic surgeons at IU Health perform more than 3,300 joint replacements each year.

We are home to the only hospital in the United States that ranks in the Top 10 for both length of stay and readmission, two industry-wide measures of success. Learn more about the IU Health Hip & Knee Center.

Understanding Knee Replacement

You should consider a knee replacement if you've noticed increased knee pain, progressive limping, or pain that wakes you up at night. These kinds of changes indicate that knee replacement could be an option to minimize debilitating knee pain.

Who Benefits from Total Knee Replacement

People who experience the most dramatic benefits from total knee replacement are those experiencing knee pain due to:

Many people have chosen to have knee replacement surgery so they can do the things they love without pain.

Why Choose IU Health for Your Knee Replacement

Thanks to our relationship with Indiana University School of Medicine, one of the most prestigious medical schools in the country, you receive the latest treatments and benefits of research and experience. Orthopedic surgeons at IU Health perform more than 3,300 joint replacements each year.

We are home to the only hospital in the United States that ranks in the Top 10 for both length of stay and readmission, two industry-wide measures of success. Learn more about the IU Health Hip & Knee Center.

Joint replacement surgery has been performed for many years. Most people who have this surgery are able to move better and have less pain after recovery. For these reasons, total joint replacement surgery has the potential to dramatically improve quality of life for many people. In 95% of cases, a new knee joint will last 20 years or longer.

Joint replacement is a major surgery. It does have some risks. It is important that you know of possible risks and complications of joint replacement surgery and discuss them with your surgeon.

Deciding on Knee Replacement

Before you have knee replacement surgery, your doctor usually wants you to have tried other options like the ones listed above. When those options haven’t helped with your pain and function, it’s time to talk about knee replacement.

First, your doctor wants to see X-rays of your knee. After examining you and viewing these images, your doctor can recommend if surgery is a good option. If you decide this is the right step, your surgery is scheduled for a time that works well for you and when you have friends or family who can help you. You also attend a pre-surgery joint replacement class to learn what to expect from surgery.

Knee replacement surgery may not be the right option if your pain is due to nerve damage or if you're experiencing loss of motion but no pain.

Non-Operative Arthritis Treatments

As with any elective surgery, your doctor will have you try non-operative alternatives before deciding on knee replacement. For knee pain, you should explore the following:

  • Exercise/Conditioning
  • Medication, including Tylenol and anti-inflammatories, such as Advil or Motrin
  • Injections, including steroid and Synvisc and Hyalgan
  • Bracing
  • Acupuncture
  • Weight loss
  • Activity modification
  • Sometimes, other knee procedures

In many cases, one or a combination of these treatments can delay or prevent the need for knee replacement surgery.

Am I Too Young for Knee Replacement?

People from age 20 to 100 have knee replacements. In the past, joint replacement was reserved for people older than 60. Technology has improved and, today, younger people can have knee replacement, remain active and expect the joint to last a long time. Your doctor will discuss with you how active you plan to be, your overall health and the expected success of your knee replacement.

What to Expect During Knee Replacement

Your surgeon will make an 8- to 10-inch incision on the front or side of your knee to access the joint. Next, the surgeon will remove any damaged bone, put the new joint in place, and close the incision with staples or stitches.

The surgery will last for about two hours. Your surgeon may use a special cement to bond the new knee parts to your healthy bone. If cement isn’t used, the artificial parts of your new joint grow together with your existing bone. You’re more likely to have an uncemented procedure if you’re younger and healthier.

Watch: What to Expect with Knee Replacement

What to Expect From Total Knee Replacement Surgery

Joint replacement surgery has been performed for many years. Most people who have this surgery are able to move better and have less pain after recovery. For these reasons, total joint replacement surgery has the potential to dramatically improve quality of life for many people. In 95% of cases, a new knee joint will last 20 years or longer.

Joint replacement is a major surgery. It does have some risks. It is important that you know of possible risks and complications of joint replacement surgery and discuss them with your surgeon.

Deciding on Knee Replacement

Before you have knee replacement surgery, your doctor usually wants you to have tried other options like the ones listed above. When those options haven’t helped with your pain and function, it’s time to talk about knee replacement.

First, your doctor wants to see X-rays of your knee. After examining you and viewing these images, your doctor can recommend if surgery is a good option. If you decide this is the right step, your surgery is scheduled for a time that works well for you and when you have friends or family who can help you. You also attend a pre-surgery joint replacement class to learn what to expect from surgery.

Knee replacement surgery may not be the right option if your pain is due to nerve damage or if you're experiencing loss of motion but no pain.

Non-Operative Arthritis Treatments

As with any elective surgery, your doctor will have you try non-operative alternatives before deciding on knee replacement. For knee pain, you should explore the following:

  • Exercise/Conditioning
  • Medication, including Tylenol and anti-inflammatories, such as Advil or Motrin
  • Injections, including steroid and Synvisc and Hyalgan
  • Bracing
  • Acupuncture
  • Weight loss
  • Activity modification
  • Sometimes, other knee procedures

In many cases, one or a combination of these treatments can delay or prevent the need for knee replacement surgery.

Am I Too Young for Knee Replacement?

People from age 20 to 100 have knee replacements. In the past, joint replacement was reserved for people older than 60. Technology has improved and, today, younger people can have knee replacement, remain active and expect the joint to last a long time. Your doctor will discuss with you how active you plan to be, your overall health and the expected success of your knee replacement.

What to Expect During Knee Replacement

Your surgeon will make an 8- to 10-inch incision on the front or side of your knee to access the joint. Next, the surgeon will remove any damaged bone, put the new joint in place, and close the incision with staples or stitches.

The surgery will last for about two hours. Your surgeon may use a special cement to bond the new knee parts to your healthy bone. If cement isn’t used, the artificial parts of your new joint grow together with your existing bone. You’re more likely to have an uncemented procedure if you’re younger and healthier.

Watch: What to Expect with Knee Replacement

Before your knee replacement, you will some blood tests and sometimes a chest X-ray to make sure you’re healthy enough for surgery. Your doctor will tell you which medications to stop taking right before surgery, rules about eating and drinking before surgery, and any other steps you need to take to prepare.

Knee replacement is a major surgery, and you will need help around the house until you get your mobility back. Your doctor will provide a list of steps to take in advance to make your recovery easier. This includes things like:

  • Having caregivers to help you
  • Having items you use a lot within easy reach
  • Planning a way to wash or bathe
  • Removing rugs, furniture, cords and obstacles that could cause you to trip
  • Stocking up on prepared meals and groceries

Your doctor also will tell you if you need to get crutches or a walker in advance and what to bring to the hospital.

Your Knee Replacement Healthcare Team

Your healthcare team has special training in orthopedics. They will help you through your surgery.

You, of course, are the most important member of your healthcare team. Your input will be important and you will be involved in all aspects of your care. Your support person — a loved one, friend or family member — should attend all appointments with you and be with you at all times during your hospital stay.

Your surgical team includes your orthopedic surgeon, an anesthesiologist, and registered nurse who are in charge of managing your care before, during, and after surgery.

During your hospital stay, physical and occupational therapists will work with you to boost your independence and ensure you are safe to go home. They will teach you exercises to regain muscle strength, walk with a device, and complete daily tasks.

The rest of your care team consists of case managers, pharmacists, hospitalists and support staff to make sure your surgery, hospital stay and aftercare go according to plan.

Preparing for Knee Replacement

Before your knee replacement, you will some blood tests and sometimes a chest X-ray to make sure you’re healthy enough for surgery. Your doctor will tell you which medications to stop taking right before surgery, rules about eating and drinking before surgery, and any other steps you need to take to prepare.

Knee replacement is a major surgery, and you will need help around the house until you get your mobility back. Your doctor will provide a list of steps to take in advance to make your recovery easier. This includes things like:

  • Having caregivers to help you
  • Having items you use a lot within easy reach
  • Planning a way to wash or bathe
  • Removing rugs, furniture, cords and obstacles that could cause you to trip
  • Stocking up on prepared meals and groceries

Your doctor also will tell you if you need to get crutches or a walker in advance and what to bring to the hospital.

Your Knee Replacement Healthcare Team

Your healthcare team has special training in orthopedics. They will help you through your surgery.

You, of course, are the most important member of your healthcare team. Your input will be important and you will be involved in all aspects of your care. Your support person — a loved one, friend or family member — should attend all appointments with you and be with you at all times during your hospital stay.

Your surgical team includes your orthopedic surgeon, an anesthesiologist, and registered nurse who are in charge of managing your care before, during, and after surgery.

During your hospital stay, physical and occupational therapists will work with you to boost your independence and ensure you are safe to go home. They will teach you exercises to regain muscle strength, walk with a device, and complete daily tasks.

The rest of your care team consists of case managers, pharmacists, hospitalists and support staff to make sure your surgery, hospital stay and aftercare go according to plan.

Your movement will be limited right after knee replacement surgery. You will receive fluids and medication through an IV tube and you may have a catheter to drain your urine until you can use the bathroom.

Your doctor will prescribe medication for pain.

Knee Replacement Exercises

Usually the day after surgery, a therapist will help you begin walking and moving your knee. You’ll also learn exercises to do at home to strengthen your knee.

After Your Knee Replacement Procedure

Your movement will be limited right after knee replacement surgery. You will receive fluids and medication through an IV tube and you may have a catheter to drain your urine until you can use the bathroom.

Your doctor will prescribe medication for pain.

Knee Replacement Exercises

Usually the day after surgery, a therapist will help you begin walking and moving your knee. You’ll also learn exercises to do at home to strengthen your knee.

Frequently Asked Questions About Total Knee Replacement

Deciding on Knee Replacement

Knee replacement is an elective procedure, so the ultimate decision is up to you. Your doctor will review your unique situation and discuss whether you have exhausted all non-surgical options.

Osteoarthritis occurs when cartilage on the ends of your bones deteriorates over time, causing bones to rub together. The rubbing can cause pain, swelling, and loss of joint motion. If left untreated, the joint can become stiff and prevent your knee from fully straightening or bending.

Total knee replacement is the procedure of removing damaged bone and cartilage from your thighbone, shinbone, and kneecap to replace them with artificial joints. It shapes the ends of your bones to accept the artificial implants and does not remove large sections of your bone.

Complications after knee replacement surgery are rare, but include:

  • Infection
  • Blood clots in the leg or lungs
  • Heart attack
  • Stroke
  • Nerve damage

With improvements in the technology of joint replacements, the age range for people appropriate for knee replacement has expanded over the years. In the past, joint replacement was reserved for people older than 60. Technology has improved and, today, younger people can have knee replacement, remain active and expect the joint to last a long time.

Your doctor will discuss with you how active you plan to be, your overall health, and the expected success of your knee replacement.

Knee replacement surgery is a good option if you have knee damage from a condition such as:

  • Osteoarthritis
  • Avascular necrosis (loss of bone due to insufficient blood supply)
  • Bone tumor or injury
  • Rheumatoid arthritis

About the Procedure

There are several factors that determine the life span of an artificial knee, including your level of physical activity, weight, and overall condition. A majority of knee replacements are still doing well at 15 years, and—based on laboratory testing—may continue to last as long as 25–30 years.

Your surgeon will make an incision on the front or side of your knee to access the joint. There are a variety of things that contribute to the length of the incision. These include, but are not limited to, patient size, muscularity, unusual anatomy of the knee joint, and the amount of stiffness of the knee prior to surgery.

Knee replacement implants are made of a variety of materials, including titanium metal (a highly porous metal), polyethylene, and cobalt chrome. Bone cement is often used to affix the implants to the bone, but cementless versions in which the one grows into the porous surface of the implants are also used.

If you are otherwise young and healthy, you may be able to run after a knee replacement. You should talk to your doctor about whether running is a good option for you and how it might affect your knee.

It is possible that that your artificial joint could cause metal detectors to go off. If this happens, do not panic. If you are in an airport, you do not need an ID card to confirm your artificial joint, but TSA may need to use a wand or pat you down. Be prepared to experience a short delay but it should not be a serious inconvenience.

If needed, your knee replacement can be repaired. This may include replacing part or all of the knee replacement. Your doctor will discuss the details of your particular revision with you.

Improvements in technology and surgical instruments have allowed incision sizes to become smaller, which may cause less soft tissue damage and allow for faster recovery.

Partial knee replacements replace only the part of the knee joint that is damaged and is an option for some people with specific joint damage and symptoms. This typically allows for a faster recovery and a more natural-feeling knee.

Recovering from Surgery

Most of the time, you can expect to be discharged from the hospital the same day or next day after surgery. The majority of your recovery will occur in the first few months, but you will continue to recover for the whole first year following surgery.

Patients with medical issues or more complicated surgical procedures may be required to stay in the hospital longer and take longer to recover fully.

A physical therapist will have you out of bed and moving on the day of your surgery. You will use crutches or a walker as you take your first steps.

Pain is handled and experienced very differently by everyone. With improvements in types of anesthesia, various blocks, and the use of a variety of pain medications designed to work together, the pain is typically very manageable after surgery.

After surgery—typically the same day—a physical therapist will teach you knee replacement exercises to help you gain strength and motion in your new knee. After leaving the hospital, you may work with a physical therapist at your home, in an outpatient physical therapy facility, or in a rehabilitation facility.

Everyone is different, and you will need to discuss the specifics with your doctor. Most patients experience some post surgical pain or discomfort for 4–12 weeks following surgery, but it typically decreases in severity each week.

You should focus on weaning off the pain medication as quickly as you are able. Pain medications have their own set of side effects, some of which can be very difficult to manage. Typically, you will have goal of weaning off prescription pain medications in 2–6 weeks.

Everyone recovers from surgery differently, but typically patients are clear to drive in 2–6 weeks, and—depending on the amount of physical activity your job requires—you can usually return to work 4–8 weeks after the procedure.

You should talk with your doctor before resuming activities like driving or working.

Everyone experiences pain differently, but improvements in types of anesthesia, various blocks, and the use of a variety of pain medications designed to work together mean the pain is typically manageable after surgery.

Knee replacement surgery, however, can be a difficult recovery and will take some time before you fully appreciate the benefits of it. Swelling and range of motion exercises contribute to the difficulty, although these are important for helping the joint to regain motion. The pain will likely be different than the pain you had before surgery, and it will get better. Pain medication, ice, and elevation will be keys to managing your pain while you recover.

Follow your doctor’s instructions in the early recovery period. Long term care of your knee replacement usually consists of avoiding repetitive, high impact activities, taking antibiotics an hour before dental appointments, maintaining your health, and properly managing any medical issues you may have.

Some patients are healthy enough to have both knees replaced at the same time. This is called bilateral total joint replacement. Otherwise, you should wait at least 3 months between surgeries to allow yourself time to recover from the initial procedure. Talk to your doctor about what is best for you.

Apr 05

Walking through the knee pain: When is it time to seek help

Pam Robbin went in for physical therapy to fix her knee pain. After several months, she decided it was time for surgery.

Walking through the knee pain: When is it time to seek help image.

Patient Stories for Knee Replacement Surgery

Apr 05

Walking through the knee pain: When is it time to seek help

Pam Robbin went in for physical therapy to fix her knee pain. After several months, she decided it was time for surgery.

Walking through the knee pain: When is it time to seek help image.

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