A total knee arthroplasty (“total knee”) is recommended for patients suffering from moderate to severe degenerative osteoarthritis. The degenerative or diseased cartilage is replaced with metal. A metal cap is placed on the end of the femur (thigh bone) and on the top of the tibia (shin bone) with a plastic insert spacer between them. The cartilage on the patella (knee cap) is also replaced with a plastic insert.
Total knee arthroplasty is an elective procedure. The patient decides when to proceed with surgery. Most patients choose surgery once their symptoms are significantly affecting their quality of life and activities of daily living or if they have failed conservative treatment.
Total knee arthroplasty is designed to take patients’ pain down from a 9-10 on the pain scale to a 1-2. The total knee replacement does not last forever. Often a knee replacement lasts between 15-25 years. It lasts longer in less-active patients, older patients, and patients with a healthy body weight. The total knee may wear out quicker in patients who are younger, more active, or overweight.
The surgery is inpatient surgery, meaning you stay in the hospital for 2-3 days following surgery for pain control and medical management. You can walk on it right away with assistance from physical therapy in the hospital. After your stay in the hospital, you can decide either to go home or to a rehab facility/skilled nursing facility to continue physical therapy. This is typically dependent upon the resources you have at home (how much help you have and how easily you can navigate your home environment) and how well you are progressing with ambulation and movement of your knee. The length of stay at the nursing facility is variable and typically lasts two weeks. If you are being discharged home following your hospital stay, you will be set up with home health care for physical therapy at home for two weeks.
You follow up with Dr. Branam 2 weeks post-op, at which time we remove your staples and recommend outpatient physical therapy. A reasonable goal would be to have 90% of your knee motion back at 6 weeks. Many patients are often 90% improved by 3 months after surgery. Often patients can get better up to a year after surgery. Following surgery, we recommend avoiding high-impact activities that create constant pounding on the knee, i.e. running/jogging.