Who is suited for knee replacement?

The most common reason patients undergo knee replacement is wear and tear of the knee joint known as osteoarthritis.  In this condition, the knee is severely damaged and all of the internal tissues including the cartilage padding and meniscus shock absorber are beyond repair.  The bones rub against one another and cause pain, stiffness, and progressive difficulty with walking.  Simple activities such as walking around the block or getting through the grocery store can become very challenging or impossible.  Walking and recreational activities such as golf become more difficult to enjoy and the pain begins prevalent throughout the day and sometimes at night.  Many patients require a cane or walker.  Most patients having knee replacement have tried nonsurgical methods of relief including injections, oral medicines, braces, and exercises, among others.  Whether you have been treated for osteoarthritis or are seeking evaluation for pain, Dr. Obermeyer will review your condition and discuss with you whether knee replacement will benefit you.  Usually X-rays will be obtained for your condition and you will be able to see the extent of damage to the joint.

What is done during knee replacement?

Knee replacement is a procedure through the front of your knee where the damaged and arthritic knee joint is resected or cut out and a new knee is implanted composed of metal and plastic.  The procedure takes approximately one hour.  The new knee is fixed to the bones using an extremely strong cement material.  The replacement joint effectively “resurfaces” the damaged thigh, shin, and kneecap bones and fixes new metal and plastic parts to alleviate pain, improve motion, and facilitate walking and activity.  Your normal tendons and ligaments on the sides of the knee are retained in their normal position.  In patients with severely deformed knees, the replacement can release the stiffened tissues and correct any deformity of the bones, which can straighten the leg and allow you to walk more easily.  During your consultation, Dr. Obermeyer will review with you more details of what knee replacement entails.

Is knee replacement likely to help?

Knee replacement has been successfully performed since the 1960s and it has grown immensely in popularity since that time due to improved access to treatment, vast improvements in the technology of the surgical implants and instruments, and the overwhelming success of the operation.  Knee replacement has been considered one of the most successful procedures in all of medicine due to its relative safety and ability to improve pain and quality of life.  The majority of patients having knee replacement is satisfied with their results and would have the surgery again.  Every patient is unique, however, and it is important to discuss specific individual factors with Dr. Obermeyer that can help guide your expectations following knee replacement. 

What are the risks of knee replacement?

As with any operation, there are several risks involved with replacement surgery.  Dr. Obermeyer, your anesthesiologist, and the surgical facility go to great lengths to minimize these risks to make them very infrequent.  Dr. Obermeyer will review the risks of surgery in detail with you and the steps that are done to minimize each risk. Do not hesitate to ask questions at your consultation to ensure they are answered to your satisfaction.

What is the recovery like after knee replacement?

Knee replacement typically involves a brief hospital stay averaging a couple nights, although innovations in pain management techniques and emphasis on early activity and mobilization have greatly reduced the duration of hospital stays, and some patients can even leave the surgical facility the same day.  Patients are encouraged to move the knee and walk immediately following surgery.  Pain management is facilitated by nerve “blocks” which deadens the pain at the knee and allows you to get up and walk very early after the procedure.  Many patients go home after their hospital stay, although some require more intensive support at a skilled nursing or other facility.  There is a brace worn for a couple days to prevent the knee from buckling.  Physical therapists are often critical in helping you in the early stages of recovery to help you walk and regain the motion in the joint. Most patients are walking well with some assistance after a couple weeks and almost all daily activities are resumed by one month.  Driving is usually begun again in approximately one month.  Most patients can resume recreational activities such as golf around 2-3 months after the procedure. After you have regained the motion and walking ability, you will experience improvements in the function of your new knee up to one year after surgery and beyond.  Dr. Obermeyer will help guide you on more specific expectations that may be unique to your case.

How long does a knee replacement last?

We know now that knee replacements continue to function well at over 15 years after initial implantation.  Due to innovations in the methods by which the thin plastic liner is engineered, wear rates in modern designs are exponentially lower than models initially utilized, even when compared with those in the last couple decades.  In fact, most studies demonstrate the need for any further surgery for your knee replacement after you recover would be more likely to occur for issues like falls and broken bones, infection, or other unexpected long term complications than for wearing out.  Wear and loosening are risks, however, and Dr. Obermeyer can guide you on your specific activity goals to ensure your new knee replacement functions well for a very long time.