Thinking about knee replacement? Here’s what you should know

If you’re experiencing knee pain, you’re not alone — this ailment affects approximately 25 percent of adults. When persistent knee pain interferes with your ability to perform daily activities like walking, standing or exercising, it may be time to consider knee replacement surgery.

Most of us know at least one person who has undergone this procedure. Also known as knee arthroplasty, knee replacement surgery is one of the most common elective surgical procedures in the U.S., and according to the American Academy of Orthopaedic Surgeons, also one of the most successful.

Zachary Adler, MD, an orthopedic surgeon, shares insight about who is a good candidate for this procedure and what to expect.

What is knee replacement?

The most common reason orthopedic surgeons perform knee replacement is to improve mobility and relieve pain from osteoarthritis, a disease caused by general wear and tear to the cartilage and bones in the knee. Other situations where knee replacement may be appropriate include pain caused by injuries to the knee or some inflammatory diseases.

“During knee replacement surgery, we remove the structures — cartilage and part of the bone — that have been worn down and are no longer providing people the cushion they need to move comfortably. Then we replace them with an artificial joint made of metal and plastic,” Dr. Adler says. “The whole procedure takes about an hour. Depending on a patient’s medical history, they can be asleep during the surgery or receive a form of anesthesia where they remain awake with sedation but don’t feel anything below the waist.”

In some cases, orthopedic surgeons use robot- or computer-assisted technology, which can aid surgical planning and precision. Patients can expect an artificial knee joint to function well for 15 to 25 years.

5 things to know about knee replacement surgery and recovery

1. Explore other options for pain relief first. While knee replacement surgery is highly effective for alleviating pain, patients and physicians typically only consider it when non-surgical treatments fail to provide lasting relief. Non-surgical options for pain relief include physical therapy, medications, corticosteroid injections and anti-inflammatory food choices, among others.

“Among all knee replacement surgeries in the U.S., there is an approximately 80 to 90 percent success rate, meaning most people are pleased with the results of the procedure,” Dr. Adler says. “The patients who aren’t as happy tend to be those who tried fewer non-surgical options first or have less advanced arthritis.”

2. Maintain realistic expectations about what surgery can do for you. “Sometimes people are surprised that knee replacement surgery isn’t going to put them in a position where they can return to strenuous activities that they used to do years ago, like marathon running, for example,” Dr. Adler says. “Knee replacement can’t really turn back the clock in that way, but what it can do is relieve pain and help people get back to doing everyday-type activities or low-intensity exercise, like swimming or hiking.”

3. Knee replacement surgery is not a good solution for all knee pain. Before moving forward with knee replacement, it’s important to pinpoint both the source and nature of your pain. X-rays are one tool your orthopedic provider will use to understand what’s happening inside your knee and ensure that surgery is a good fit for you.

“If your X-rays don’t indicate the effects of severe arthritis in your knee, then knee replacement may not be the best solution for relieving your pain,” Dr. Adler says. “If that’s the case, we can work together on identifying the source of your pain, finding alternatives for symptom relief and helping you reach your functional goals.”

4. You’ll be up and moving the same day as your surgery. Knee replacement surgery has come a long way since it was first developed in 1968. In years past, patients spent several days or weeks recuperating in the hospital and did not put any weight on their knee for some time after surgery, but not anymore.

“Advances in anesthesia and our approach to therapy mean that we get people up and moving the day of their surgery, which is better for their long-term recovery,” Dr. Adler says.  “Often, people can even go home on the same day as their surgery.”

5. Recovery for knee replacement surgery can take up to six weeks. “The first two to three weeks following knee replacement are the most difficult part of recovery —there can be some pain and muscle soreness,” Dr. Adler says. “While people are fully weight-bearing during this time, most use a walker to help them get around.”

During recovery, your surgeon will recommend exercises you can do at home to maintain your range of motion and build strength. A majority of people return to most daily activities within three to six weeks after surgery. Keep in mind that the state of your health prior to surgery will affect how quickly you recuperate.

“Knee replacement can make a big difference in a person’s quality of life — making it possible for them to get back to doing the activities they love, whether that’s playing with their grandkids or going for long walks in their neighborhood,” Dr. Adler says. “The most important thing for people to remember is that every person and every knee is different. Your orthopedic provider will work closely with you to help you figure out if and when knee replacement surgery is a good option.”

Learn more about finding relief for knee pain by visiting MultiCare Orthopedics & Sports Medicine.