Total Knee Replacement
Is total knee replacement right for me?
You may be a candidate for a total knee replacement if other treatments for knee osteoarthritis have failed to relieve your symptoms. You may be a candidate if you have tried the following treatments without success:
- Physical therapy
- Unloader knee braces
- Anti-inflammatory medication
- Cortisone injections
- Viscosupplement therapy
Additionally, if your pain is negatively affecting your daily activities and keeping you awake at night, you may also be a candidate for total knee replacement surgery.
You may be a candidate for a total knee replacement if you have failed other treatments for osteoarthritis of the knee. These include no improvement in your symptoms after trying any of the following: physical therapy, unloader knee braces, anti-inflammatory medication, cortisone injections, and/or viscosupplement therapy. Additionally, if your pain is negatively affecting your activities of daily living and keeping you awake at night, you may also be a candidate.
About the procedure
During a total knee replacement, the old damaged bone of your joint surfaces is removed and replaced with metal, plastic, and/or ceramic components. The joint surfaces that are replaced include the:
- Femur (thighbone)
- Tibia (shinbone)
- Patella (kneecap)
What is a minimally invasive total knee replacement?
Traditionally, knee replacements have been performed through a long incision on the front of the knee. Recently, minimally invasive surgical techniques have become popular among orthopedic specialists. Using these techniques:
- The quadriceps muscle (on the front of the thigh) is spared
- The incision is smaller
- The patient may experience less scarring and pain after the procedure
In truth, all knee replacement surgeries have become more “minimally invasive.” As medical knowledge in this area improves, the orthopedic specialists at Summit Orthopedics have become more efficient in their techniques, resulting in better outcomes for our patients.
What is a computer-assisted total knee replacement?
Another new development in the world of joint replacement has been the advancement of computers as a surgical tool. During a computer-assisted total knee replacement, your specialist utilizes a computer program to map the surfaces of your joint. This ensures a precise fit and alignment of the total knee replacement components.
When is total knee replacement surgery recommended?
If nonsurgical treatments like medications, physical therapy, injections, and walking supports are not helpful, total knee replacement surgery may be an appropriate option for you. The surgery is a safe and effective way to relieve pain, correct leg deformity, and help you resume normal activities.
Your doctor may recommend knee replacement surgery if you have:
- Severe knee pain or stiffness that limits everyday activities
- Moderate or severe knee pain while resting, either day or night
- Chronic knee inflammation and swelling that does not improve with rest or medications
- A knee deformity, such as bowing in or out of your knee
The decision to perform total knee replacement surgery is based on pain and disability as well as your health and associated medical conditions. Most patients who undergo total knee replacement are age 50 to 80.
Award-winning, advanced surgical facilities Summit Orthopedics’ Vadnais Heights Surgery Center received The Joint Commission’s Advanced Certification for Total Hip and Total Knee Replacement for innovation and patient safety. The center is one of just two nationwide to receive the prestigious certification. Learn more.
Preparing for total knee replacement surgery
Several steps need to be completed in the weeks before surgery:
- You must have a preoperative (pre-op) history and physical with your primary care provider within 30 days of surgery. The results should be faxed to the facility where your surgery is scheduled, and you should bring a physical copy of the original form with you to surgery.
- There are several joint replacement education classes in the Twin Cities area. In these classes, fellow joint replacement candidates gather and learn about what to expect before, during, and after surgery. This is a wonderful opportunity to become more comfortable with this period of transition in your life, and we encourage our patients to participate. Your specialist’s patient coordinator can help you find a class that works with your schedule.
- Discontinue the use of vitamin E three weeks before surgery.
- Prepare your house for your return after surgery. Simple things like cleaning up any clutter on the floor, clearing space to maneuver a walker, and placing a chair in your shower stall can all help decrease the risk of an accidental fall.
- Any dental procedures need to be completed at least one month before your surgery. In dental procedures, bacteria can enter the bloodstream, causing infection and dramatically affecting your chances for a successful surgical outcome.
- Notify your specialist if you become ill with a cold, fever, congestion, etc., the week before surgery. We may need to reschedule your surgery.
The following will need to be done in the days leading up to your surgery:
- Do not smoke after midnight the night before your surgery.
- Do not drink alcohol for 24 hours before your surgery.
- Do not take any NSAIDs, aspirin, or herbal supplements for one week before your surgery.
- If you are taking prescription blood thinners such as Coumadin (warfarin), Ticlid (ticlopidine), or Plavix (clopidogrel bisulfate), among others, please inform your specialist’s patient care coordinator. These medications will need to be stopped before the procedure, but only after you receive permission from the physician who is prescribing these medications.
- A nurse from the hospital or surgery center will contact you 24 hours before your surgery to tell you at what time your surgery is scheduled and to answer any questions you may have.
The day of your total knee replacement surgery
Arrive at the hospital or surgery center two hours prior to your surgery. During this time, your nurses may run minor tests, check your blood pressure, and take your pulse. Your anesthesiologist will meet with you to discuss the type of anesthesia you will receive.
For more information, please refer to the presurgery handout you received.
Antibiotics are administered prior to surgery to help protect against any potential infection. During this time, your family may remain with you until you are taken to surgery. A member of your specialist’s team will also come in and address any last-minute questions or concerns you might have.
What can I expect after total knee replacement surgery?
- You will spend several hours in a recovery room after surgery so that we can monitor you closely as the anesthesia wears off. During this time, your family will be notified that the surgery is complete and that you are in recovery.
- After the effects of the anesthesia have worn off and you are medically stable, you will be moved to a hospital or Care Suites room, and your family will be able to visit you.
- Most joint replacement patients go home the same day if they have their procedures done at a surgery center. Some patients choose to stay in the Care Suites overnight. If a patient chooses to have the surgery in the hospital, the patient is generally admitted for one or two nights.
- During your stay, you will participate in physical therapy several times a day. Patients staying in Care Suites are also able to use our Secure Tracks specialty physical therapy device.
Contact your specialist immediately if you develop a fever or chills, pain that is not relieved by medication, excessive unrelenting drainage, calf pain, or if you fall. Call 911 immediately if you experience any shortness of breath or develop chest pain.
Leaving the hospital or Care Suites
Before surgery, you and your physician will establish a plan for where you will be discharged after surgery and who will be caring for you. After you go home, you’ll come to our physical therapy facility twice a week for ongoing rehabilitation.
Your first follow-up visit
After surgery, your treatment team will want to see you in clinic. At this appointment, you can expect to have any remaining staples removed, have X-rays taken, and receive instructions and guidelines for the next four to six weeks. Your specialist will also check on your progress with physical therapy.
Potential complications during and after total knee replacement surgery
It is important to have realistic expectations about your total knee replacement surgery. Although they are rare, there are potential complications with any surgery, and you are expected to have a reasonable understanding of the risks. Please refer to our preoperative informational handout for further information regarding potential complications and risks associated with surgery.
Our goal at Summit Orthopedics is to assist you in this regard and help you have the best experience possible as you transition into this new phase of your life. Should you have any questions or concerns, please contact your specialist’s team. They are available to help you and address any questions or concerns that you may have.
When to seek treatment for your arthritis
Arthritis doesn’t have to spell the end of an active life. If you are experiencing worrisome symptoms or persistent pain, the renowned arthritis specialists at Summit Orthopedics can help. We work with you to confirm a diagnosis and develop an appropriate conservative treatment plan. If nonsurgical treatments fail to support your lifestyle goals, fellowship-trained orthopedic surgeons will consult with you and discuss appropriate surgical options. Summit is home to innovative joint replacement options. Our Vadnais Heights Surgery Center is one of a select few nationally to receive The Joint Commission’s Advanced Certification for Total Hip and Total Knee Replacement.
Summit has convenient locations across the Minneapolis-St. Paul metro area, serving Minnesota and western Wisconsin. We have state-of-the-art centers for comprehensive orthopedic care in Eagan, MN, Vadnais Heights, MN, and Woodbury, MN, as well as additional community clinics throughout the metro and southern Minnesota.
Surgical advances improve patient outcomes and patient experience.
Physical therapy during rehabilitation plays a critical role in the success of total joint surgeries. Dr. Hansen explains that understanding what to expect after a joint replacement can help patients to maximize the success of their surgical outcome.
Often, knee pain can be controlled with nonsurgical treatment. When these treatments fail to manage pain, Dr. Hansen explains the available surgical options.