- How do I know if I need a knee replacement?
This is probably the most common question I get. Short answer is…you will know. When you have these key signs- it’s time to have THE DISCUSSION
Key signs to be on the look out for
- knee pain starts to affect your daily activities
- You avoid things you enjoy because you know your knee will hurt
- Knee pain awakes you from sleep at night
- You dread doing simple things such as going to the grocery
- How long is the recovery
- Our goal is to get up and walk day 1
- By 6 weeks you’re pretty happy you had the surgery but still have some night time achiness.
- 75% of your recovery is in the first 3 months. If your job requires walking several miles during the day or up and down ladders all day, it’s about 3 months until your ready for this level of activity
- At 3 months you can do anything you want with the knee, but if you still do “too much” it will talk back to you (swell, and get a bit inflamed)
- Most studies suggest it can take a full YEAR to fully recover
- How soon will I start walking and driving
- This is the breakdown from the day of surgery
- Our goal is to get up and walk day 1 of surgery
- Most patients go home the day after surgery
- Most patients walk with a walker a 1-2 weeks, a cane 1-2 weeks and don’t need any assisted device (cane or walker) by 4-6 weeks. That being said, I have 80+ year old patients walk in at 2 weeks with nothing!
- If you have your LEFT knee replaced you can start driving when not taking the strong pain medications.
- If it’s your RIGHT knee being replaced, typically its 3-4 weeks before comfortable driving
- This is the breakdown from the day of surgery
- How long do the implants last
90% of the implants are still on the road at about 20 years. The 10% that fail prior to that are usually do to infection of the knee or the implants become loose for a very odd reason
- How much pain will I be in after surgery?
Depends on how tough you are. Everyone’s pain tolerance is different. I have patient’s daily who tell me “Doc I have a very high pain tolerance”. Truth is most who come out and say that really don’t have much of a pain tolerance which is ok. Going in we know everyone will be different.
- With our modern techniques and multi-modal pain management protocols, knee replacements today are less painful than they’ve ever been
- The first few weeks are the toughest but with routine Icing of the knee and our multi-modal medications, the pain improves almost daily
- By 6 weeks you’re pretty happy you had it done and night time achiness is the norm
- By 3 months pain is minimal
- What are the most common risks of knee replacement
- is the big one we worry about and unfortunately its not too common. Infection risk is about 1-2%. Morbid obesity (BMI >40), smoking, poorly controlled diabetes are the big factors that really place you at risk for complications after any major surgery like knee replacement
- (1-2%). This would require us to go back in and replace the parts and is called a revision knee replacement
- ( 3%) – we will place you on a blood thinner such as Aspirin or Lovenox for 30 days to significantly reduce the chance of blood clots
- Will I be completely pain free?
- A lot of patients often start this question with “Mr/Mrs. X had a knee replacement and they still have all kinds of problems.” If you look at the studies we get a good breakdown. If you take 100 patients across the country, 80% will have very little to no pain. 10-15% will have some pain but still very happy they had the surgery. The last 5-10% still have problems. This could either because of stiffness (not doing their exercises), infection referred pain from a hip or low back problem. Sometimes they just hurt and we can’t find an identifiable cause.
- How long does the surgery last? Typically the surgery lasts about 2 hours. Once the surgery is complete, you will be in the recovery area about an hour before heading back to your room.
- How long am I in the hospital? 90% of our patients now go home the next day. If you are very healthy and we have all the therapy set up some patients will go home the same day of surgery
- Is there any harm in waiting? Great question! I typically recommend Xrays at least once per year to follow the progression of knee arthritis because-YES- it will get worse. 2 big signs that you need to really consider surgery is if there is evidence of significant bone loss (bone is wearing away) or if the thigh bone and shin bones are sliding off each other (joint is subluxing). This can compromise your outcome after surgery and require us to use larger implants which have a higher chance of loosening down the road. If this happens you’ll have to have a revision replacement which carries higher risks and longer recovery.