When pain in your knee makes it difficult to walk, take the stairs and work, it can greatly impact your quality of life. And if non-surgical treatments have been unsuccessful, your doctor may recommend total knee replacement (TKR) surgery. If you’re considering TKR, you probably have questions.
What is total knee replacement?
TKR (or arthroplasty) is a surgical procedure using metal and plastic parts to cap the ends of your bones that become the knee joint, as well as the knee cap. By resurfacing the parts of the knee joint that are damages, the knee pain you experience is alleviated.
Is it painful?
During the procedure your doctor will use nerve blocks and other means to control pain, and afterward you may experience mild pain or more lingering pain. That’s because everyone’s tolerance to pain is unique. As early as the day after surgery, you will be able to stand and move the joint with assistance. By adopting an early range of motion, you will help to reduce stiffness and pain much sooner.
How long is the hospital stay?
Typically, you will stay in the hospital from one to three days, depending on how well you take to your physical therapy. Other factor that determine your length of stay include your condition before surgery, your age, and any medical problems you have that may affect how you recover.
How long will it take to recover?
You can expect to return to most of your regular activities in about three months. But to fully recover, plan on six months in order to have the strength and endurance you had pre-surgery.
Is physical therapy necessary?
In general, you will be required to participate in outpatient physical therapy after surgery. This is an important part of your recovery process and will get you on the road to optimal mobility in a shorter period of time. How much physical therapy you need will depend on your condition before surgery, your dedication to the process and your overall health.
How long will by new knee last?
In most cases, a joint replacement lasts between 15 to 20 years. It is important to follow up with your doctor after surgery to ensure that your replacement is continuing to function well.
Most modern knee replacements function well for many years, and current implants commonly last two decades or more in appropriately selected patients. Younger and more active patients carry a higher chance of eventually needing a revision.
Most patients walk with support within days and resume routine activities over roughly three months, with strength and comfort continuing to improve for up to a year. Committed physical therapy is the strongest predictor of a good result.
The principal risks are infection, blood clots, stiffness and loosening of the implant over time. These are uncommon, but they are the reason surgery is reserved for knees that no longer respond to non-surgical care.
In many cases yes, and delaying is often preferable for younger patients who would otherwise face a revision later in life. The main caution is allowing severe deformity or muscle loss to develop, which can make the eventual surgery harder.
Most patients return comfortably to walking, cycling, swimming and golf, while high impact running and jumping are generally discouraged because they accelerate implant wear.
Reviewed by Dr. Richard Scheinberg, MD, a board-certified orthopedic surgeon in Santa Barbara with 40 years of surgical experience.
