You could find it challenging to perform basic activities like walking or climbing stairs if your knee is significantly damaged due to arthritis or an injury. You could even start experiencing pain while sitting or lying down. Consider total knee replacement surgery if other options like prescription drugs and walking aids are no longer effective. Surgery can reduce discomfort, treat deformity, and enable you to return to regular activities.

Knee replacement, also known as total knee replacement or knee arthroplasty, is a surgical process used to repair an arthritis-damaged knee. Plastic and metal components, along with a kneecap, are used to cap the ends of the bones, which form the knee joint. Someone with a severe knee injury or arthritis may benefit from this surgery. If you have suffered arthritis or knee injury and require a total knee replacement in Las Vegas, Suarez Physical Therapy can help.

Understanding Total Knee Replacement

The first knee replacement procedure was carried out in 1968. Since then, surgical equipment and methods advancements have significantly boosted their efficacy. Total knee replacement ranks among the most successful medical procedures.

Several types of arthritis could affect the knee joint. Osteoarthritis, a degenerative joint condition primarily affecting middle-aged and older persons, can destroy knee joint cartilage and surrounding bone. Rheumatoid arthritis that results in increased synovial fluid and synovial membrane inflammation can cause discomfort and stiffness. Traumatic arthritis, or arthritis brought on by an injury, can damage knee cartilage. Knee replacement surgery aims to reconstruct the damaged areas of the knee joint and to cure persistent knee pain resistant to other care forms.

An orthopedic surgeon evaluates your knee's range of motion, strength, and stability to determine if a knee replacement is appropriate. X-rays assist in assessing the extent of the damage. Then, depending on your age, weight, knee size and shape, activity level, and overall health, your doctor can select from several knee replacement prostheses or surgical techniques.

The Anatomy Of The Knee

The knee is the body's largest joint, and healthy knees are necessary for most daily activities. Joints are the points at which two or more bones connect. The majority of joints are mobile, which allows the bones to move. The knee contains two leg bones secured together by ligaments, muscles, and tendons. A layer of cartilage covers the bone ends, helping to absorb shock and protect the knee.

The knee contains two groups of muscles, the quadriceps, and hamstring, which work together. The quadriceps are on the front of the thighs and are responsible for straightening the legs. The hamstring muscles lie at the back of the thighs and help bend the knee.

Tendons, which are strong cords of connective tissue, link the bones and the muscles. Ligaments are elastic tissue bands that join one bone to another. While some knee ligaments support and shield the joints, other ligaments prevent the tibia from moving forward or backward.

  • The tibia is the shinbone or the more prominent bone within the lower leg.
  • The femur is the thigh bone, also known as the upper leg bone.
  • Patella — This is known as the kneecap.
  • Cartilage — Tissue that coats the bone's surface at a joint; cartilage aids in the reduction of friction during joint movement.
  • The synovial membrane is a tissue that lines and seals the joint to form a capsule. For you to lubricate the joint, the synovial membrane secretes and produces the synovial fluid (a clear, sticky fluid).
  • Ligament — A tough, elastic connective tissue surrounding the joint to provide support and limit movement of the joint
  • Tendon — A tough connective tissue that connects the muscles to bones. It helps control joint movement.
  • Meniscus — A curved section of cartilage within the knees and other joints, which acts as a shock absorber, expands the contact area, and deepens the knee joint.

Whether Knee Replacement Is Right For You

You, your primary care physician, your family, and your orthopedic surgeon should all work together to decide if you should undergo a total knee replacement. If you think you could benefit from the procedure, your doctor could recommend getting a comprehensive evaluation from an orthopedic surgeon.

Your doctor could recommend knee replacement surgery for numerous reasons. Individuals who benefit from a total knee replacement surgery have the following:

  • Severe knee discomfort or stiffness that makes it difficult to walk, climb stairs, or get in and out of seats. It could be challenging to walk a few blocks without experiencing substantial discomfort, necessitating using a cane or walker.
  • Knee pain, either moderate or severe, when lying down, day or night
  • Chronic swelling on the knees or inflammation that does not heal with rest and medication
  • Knee malformation, including knees that bow in and out,
  • Failure to improve with other therapies like cortisone injections, painkillers, physical therapy, inflammatory medications, or other interventions

The Candidates For Knee Replacement Surgery

Absolute limitations on weight or age do not exist for complete knee replacements.

Surgery recommendations depend on a patient's pain level and level of disability, not on their age. Orthopedic surgeons analyze each patient individually; however, most total knee replacement patients are between 50 and 80. From young teenagers with juvenile arthritis to elderly patients with degenerative arthritis, total knee replacements have been successfully performed at all ages.

Knee replacement surgery can be used to relieve knee pain and impairment. Osteoarthritis is the most frequent ailment that necessitates knee replacement surgery.

Joint cartilage degeneration is a prominent symptom of osteoarthritis. Movement is limited and could be painful due to bone and cartilage damage. People with severe degenerative joint illness could find it painful to perform daily activities like walking or climbing stairs, which require bending at the knee. In addition, the instability of the joint can cause the knee to swell or "give way."

Degeneration of the knee joint can also arise from other types of arthritis, including rheumatoid arthritis and arthritis caused by a knee injury. In addition, the knee joint can suffer irreparable harm from fractures, cartilage tears, and/or torn ligaments.

Knee replacement surgery can be successful if other medical options are ineffective. The following are alternative medical remedies for degenerative joint disease:

  • Pain medications
  • Anti-inflammatory medications
  • Glucosamine and chondroitin
  • Physical therapy
  • Assistive walking devices like canes
  • Limiting painful activities
  • Cortisone injections in the knee
  • Weight loss for obese people
  • Viscosupplementation injections help to add lubrication to the joint, causing less discomfort when moving the joint.

The Orthopedic Evaluation

Before you undergo knee replacement surgery, you will undergo an intense orthopedic evaluation to determine if you are a good candidate for the procedure. An orthopedic evaluation consists of the following:

  • Medical background — Your orthopedic surgeon will ask you about your general health, your knee pain severity, and your capacity to function.
  • The knee's motion, strength, stability, and overall leg alignment will be assessed.
  • X-rays — These images aid in determining the extent of the knee's damage or deformity.
  • Other examinations — Blood samples or advanced imaging, like an MRI scan, may be required to determine the state of your knee's bone and soft tissues.

Your orthopedic physician will review the evaluation's findings with you and decide whether a knee replacement is an ideal option for reducing pain and restoring function. The physician will also review and discuss whether there are any other viable treatment alternatives, like drugs, physical therapy, injections, or different kinds of surgery. Your orthopedic physician will also review any risks and issues that could arise from a total knee arthroplasty, including those connected to the procedure and those that could develop later on.

Deciding To Undergo A Knee Replacement Surgery

Understanding what knee surgery can and cannot achieve is crucial in determining whether to undergo total knee replacement.

Most patients who undergo complete knee replacement surgery report significantly less knee discomfort and a considerable increase in their capacity to carry out routine daily tasks. However, a total knee replacement cannot give you any greater mobility than you had before the onset of arthritis.

With regular use and movement, a knee replacement implant starts to deteriorate in its plastic spacer. In addition, increased activity or weight gain may hasten this natural wear, resulting in the knee replacement becoming loose and uncomfortable. Therefore, most physicians advise against engaging in high-impact activities or sports like running, jumping, and jogging after the procedure.

Swimming, walking, golfing, driving, biking, light hiking, riding, ballroom dancing, and other low-impact sports are safe after total knee replacement. Knee replacements could last for years with proper activity modification. 

Before The Knee Replacement Surgery

Here is what you should expect before undergoing knee replacement surgery:

  • You will be required to sign a consent form to proceed with the procedure. Thoroughly read it and ask questions if anything on the form is unclear, then ask questions.
  • Before the operation, your doctor will perform a thorough physical examination and obtain a comprehensive medical history. Then, you can be subjected to diagnostic procedures like blood tests.
  • Inform your doctor if you are sensitive to or allergic to any drugs, tape, latex, or anesthetics (local and general).
  • Inform your physician of all prescription, herbal, and over-the-counter supplements you are taking. If you have a prior history of bleeding issues, are currently taking aspirin or other blood thinning drugs, or any other medications, let your doctor know. You might have to stop using these medications before the operation.
  • You should tell your doctor if you are pregnant or think you might be.
  • Eight hours of fasting could be required before the surgery; in most cases, the physician will advise you not to eat after midnight.
  • Before the surgery, you can be given a sedative to help you unwind.
  • A physical therapist could visit you before surgery to talk about recovery. Then, after you leave the hospital, arrange for someone to assist you with house chores for a week or two.
  • Your doctor could suggest additional preparation depending on your health condition.

What to Expect During The Procedure

The exact knee replacement procedure will depend on your condition and the doctor's practices. A knee replacement surgery requires you to stay in the hospital. In most cases, surgeons conduct the surgery when a patient is asleep under general anesthesia. Your anesthesiologist will discuss this with you before the surgery. Here is what to expect when undergoing knee replacement surgery:

  • You will be requested to take off your clothes and handed a gown to wear
  • The physician will start an intravenous (IV) line in your hand or arm 
  • You'll be placed on an operating table.
  • In most cases, a urinary catheter will be inserted.
  • Hair at the surgical site will be clipped if it is excessive.
  • During the surgical procedure, the anesthesiologist will monitor your heart rate, breathing, blood pressure, and oxygen level.
  • An antiseptic solution will be used to clean the skin around the surgical site.
  • The surgeon will make an incision near the knee.
  • The damaged areas of the knee joint will be removed, and the joint will be resurfaced with the prosthesis. Metal and plastic are used to make the knee prosthesis. The most common form of artificial knee prosthesis is the cemented one.
  • Uncemented prostheses are no longer commonly used. Instead, surgical cement is used to secure a cemented prosthesis to the bone. An uncemented prosthesis has a porous surface on which the bone grows and attaches to the prosthesis. A combination of the two prostheses is sometimes used for knee replacement.
  • Surgical staples or stitches will be used to close the incision.
  • In order to remove fluid from the incision site, a drain may be placed.
  • A dressing or bandage will be placed on the wound.

The Possible Complications Of A Knee Replacement Surgery

Complications are uncommon after total knee replacement. Only 2% of patients experience serious complications, like a knee joint infection. Significant medical complications, like a heart attack or stroke, happen even less frequently. The risk of complications could increase if you have a chronic illness. Even though these complications are uncommon, they can delay or limit complete recovery. Before the surgery, discuss in detail your concerns with your orthopedic surgeon.

  • Infection — Infections can develop deep around the prosthesis or in the wound. It could happen days or even weeks after your surgery. Sometimes, It could happen years later. Antibiotics commonly come in handy to treat minor wound infections. Major and deep infections could necessitate additional surgery or the removal of the prosthesis. Any infection in your body can spread to the joint replacement.
  • Blood clots — One of the most frequent complications of knee replacement surgery is the formation of blood clots in the leg veins. If these clots break free and move to your lungs, they could be fatal. Your orthopedic surgeon will recommend a prevention plan that could include regular leg elevation, lower leg exercises to boost circulation, medication to thin your skin, and support stockings. 
  • Implant issues — Despite advances in implant designs, materials, and surgical techniques, implant surfaces or components could wear down or loosen. Furthermore, an average of 115° of motion is usually expected after surgery. However, knee scarring could occur, and motion could be even more limited, especially in patients who had limited motion before surgery.
  • Pain persists — A small percentage of patients experience pain even after a knee replacement. This problem, however, is uncommon, and most patients experience pain relief after knee replacement.
  • Neurovascular damage— While uncommon, nerve or blood vessel damage around the knee could occur during surgery.

After a Knee Replacement Surgery

You will remain in the recovery area for observation after the surgery. Later, you will be brought to your hospital room as soon as your breathing, blood pressure, and pulse have stabilized and you are awake. Having knee replacement surgery typically necessitates a few days of hospitalization.

Once you get home, keeping the surgery site dry and clean is crucial. You will receive specific bathing guidelines from your doctor. The surgical staples or stitches will be removed during a subsequent appointment visit.

You could be instructed to elevate your foot or apply ice to the knee to minimize swelling. As advised by your doctor, take pain medication when you are sore. Aspirin and a few other painkillers could make bleeding more likely. Make sure to take only the prescribed drugs.

Notify your doctor if you notice any of the following:

  • Increased discomfort or pain at the incision site
  • Swelling, redness, bleeding, or any other discharge from the incision site
  • Fever

Drive only after being cleared by your doctor. There can be further activity limitations. It can take several months for the knee to heal fully.

After having your knee replaced, it is crucial to avoid falling because it could damage the new joint. Your therapist could advise using a cane or walker to help you navigate your surroundings until your muscle strength and balance return.

You could make some modifications to your home to help you during recovery:

  • Dressing stick
  • Raised toilet seat
  • A shower chair or bench
  • Proper handrails along the stairs
  • Sock aid
  • Reaching stick to grab objects
  • Removing loose electrical cords and carpets that could make you trip
  • Long-handled shoe horn
  • You should avoid stair-climbing until your doctor clears you

Find Reliable Total Knee Replacement Services Near Me

If you suffer a knee injury or your knee joint deteriorates due to arthritis, there is a remedy for you. A total knee replacement surgery could restore your knee joint to normalcy. For reliable knee replacement surgery services in Las Vegas, contact Suarez Physical Therapy. Call us at 702-368-6778 to talk to one of our experts.