- When should I have a knee replacement?
- Why should I have a knee replacement?
- What is computer navigation?
- Is it true that recovery from a knee replacement is painful and difficult?
- Should I be performing exercise before surgery?
- What kind of implant does Dr. Su use?
- How long will my knee replacement last?
- What activities will I be able to perform after knee replacement?
This is an individual decision that is different for every patient. The primary reason to have a knee replacement is for pain relief. The typical patient who chooses to have knee replacement experiences pain on a regular basis, whether it be at night, taking long walks, going up and down stairs, or standing.
When knee arthritis interferes with your quality of life, a total knee replacement is a way to restore it. A successful knee replacement should relieve you of arthritic knee pain, improve your mobility, and allow you to return to activity.
Computer navigation is a method of performing a total knee replacement that allows a surgeon to prepare and insert the knee replacement more precisely. A computer does not perform the surgery, but is used as a tool to aid the surgeon to align the joint in the proper location for each individual patient. Studies have shown that computer navigation improves precision in knee replacement surgery. Dr. Su has been using computer navigation for knee replacement surgery since 2009.
Different patients will experience the recovery differently. Some will find it to be relatively painless (on medication), while others will find it to be painful and labor-intensive. At Hospital for Special Surgery, we use many techniques to attempt to control your pain after surgery, including nerve blocks and pre-emptive medications.
It is standard that you will need pain medication for a period of time after the surgery; it is also imperative that you be motivated to exercise after surgery, in order to achieve good results.
It is always a good idea to be as strong as possible when going in to surgery, so that you can be stronger coming out of surgery. I recommend strengthening the muscles around the knee, namely the quadriceps and hamstring muscles, to help with your recovery. This can be done at the gym by using the leg press, squat, extension, and curling machines.
Riding a stationary bicycle is a good way to exercise the knee and maintain range of motion, without placing excessive loads upon the knee.
Dr. Su uses a variety of implants, depending upon whether you are having a total or partial knee replacement. The implant manufacturers that he uses are: Smith and Nephew; Biomet., Stryker, and Zimmer.
For younger patients, he may suggest a ceramic-type implant that has the potential to last longer.
A typical knee replacement can last 20 years or more; however, it is subject to the loads and activities placed upon it. Walking, cycling, and swimming are gliding-type activities that are conducive to long-life of an implant. Impact sports such as basketball, volleyball, and jogging are not recommended, as they may shorten the lifespan of an artificial joint.
You should have no problem walking, hiking, dancing, biking, or swimming. Patients can also return to playing golf, and racquet sports such as tennis or squash.
Is there anything in particular that I should do before having TKR surgery?
You should do your best to have the quadriceps muscle, in the front of your thigh, as strong as possible before undergo TKR surgery. The stronger you are going in to surgery, the stronger you will be coming out, and the easier your recovery. The quad muscles are essential in supporting your knee when you walk, so weakness in this area will make you feel as though your knee will buckle.
Many patients will have already attempted physical therapy (PT) as part of the treatment for knee arthritis. In this case, you should try to reinstitute the same exercises to build up the quad muscles. If you’ve never done PT before, then pre-surgical rehabilitation (“pre-hab”) may be a good idea for you.
Should I try to increase my range of motion?
The best predictor of range of motion after surgery is range of motion before surgery. So, yes, increasing your range of motion is a good goal; however, it may be painful. Therefore, you should not try to force any movement, as there may be bone spurs blocking the movement of your knee. Riding a stationary bicycle is a good way to exercise the muscles of the thigh as well as maintain knee range of motion.