Knee Replacement Surgery

Understanding 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 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:

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

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.

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.

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.

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.