Here are the ramifications of getting a joint replaced in a nutshell. First of all, having a joint replacement is not an emergency. This is a procedure which is undertaken with the knowledge that other avenues have been pursued, but lifestyle is being negatively affected secondary to pain. The procedure is performed to try to alleviate pain and increase activity within your lifestyle. One of the most important orthopedic surgical advances of this century is knee replacement. This surgery was first performed in 1968. Improvements in surgical materials and techniques since then have greatly increased its effectiveness. About 267,000 total knee replacements are performed each year in the United States.
Am I a candidate for Total Knee Replacement Surgery?
If your knee is severely damaged by arthritis or injury, it may be hard for you to perform simple activities such as walking or climbing stairs. You may even begin to feel pain while you’re sitting or lying down.
If medications, changing your activity level, and using walking supports are no longer helpful, you may want to consider total knee replacement surgery. By resurfacing your knee’s damaged and worn surfaces, total knee replacement surgery can relieve your pain, correct your leg deformity, and help you resume your normal activities.
What should I expect at my total knee replacement consultation?
Total knee replacement is not an emergency and for most patients it’s not an absolute need. However, when patients begin to consider knee replacement, the pain is generally starting to really intrude on their lives. Activities they’ve always enjoyed are now out of the question. Just getting up out of a chair can be an exercise in moderate torture.
When you come in for your consultation with Dr. Holmes, this needs to be a complete give and take sharing of information between the two of you. Dr. Holmes wants to know where you are with your pain and how it is changing your life for the worse. He’ll want you to express what you hope to achieve with your knee replacement. He’ll want to know any questions you have about any part of the process.
Dr. Holmes will share with you what he thinks can be achieved with your replacement. He’ll also go through possible complications and setbacks. He’ll describe the surgery and your recovery.
Dr. Holmes will not be an advocate or non-advocate for you choosing to move ahead with total knee replacement. His goal is to give you all the information possible so you can feel confident in your decision.
Is Total Knee Replacement Right For You?
The decision whether to have surgery for a total knee replacement in San Antonio, TX should be a cooperative one between you, your family physician, and your orthopedic surgeon. Your physician may refer you to an orthopedic surgeon for a thorough evaluation to determine if you could benefit from the surgery.
How is Total Knee Replacement Surgery Performed?
The procedure is a resurfacing of the bones of the joint, utilizing metal on one side and metal/ plastic component on the other, thus returning slickness in the joint and taking away the bone on bone pain. It requires a hospitalization of approximately 2-3 days plus or minus depending on the patient. It requires rehabilitation either at a rehabilitation hospital and/or home for an additional three weeks plus or minus. Total joints are an extremely rewarding procedure in relieving pain with the appropriate diagnosis.
Most patients who undergo total knee replacement in San Antonio, TX are age 60 to 80 but, orthopedic surgeons evaluate patients individually. Recommendations for surgery are based on a patient’s pain and disability, not age. Patients as young as age 16 and older than 90 have undergone successful total knee replacements.
Is Total Knee Replacement Painful?
There will be pain after your anesthetic wears off. You’ll have a nerve block the day of your surgery and that has lasting anesthetic qualities. From there, you’ll be on narcotic pain medication taken orally or in IV form. This will likely be morphine, fentanyl, or oxycodone. They are addictive, but you’ll only be on them for a short while. Your pain should diminish relatively quickly, within 4 or 5 days at the most.
Future lingering pain is somewhat dependent upon you. If you follow your physical therapy diligently and make some lifestyle modifications to eliminate areas of impact, your future pain should be minimal, especially compared to your pre-surgery levels of pain.
What Can I Expect After My Knee Replacement Surgery?
There are really two parts to your recovery after total knee replacement surgery with Dr. Holmes: planning for recovery and actual physical recovery.
Planning out your recovery is one of the keys to success. It needs to be done before you’ve even scheduled your surgery. You’ll want to go through your house and check some things, such as the stability of your handrails. And you’ll need to enlist help. You will be able to walk on crutches or with a walker soon after surgery, but you’ll need help around the house for several weeks with tasks such as cooking, shopping, bathing, doing laundry, and the like.
You’ll need to get your house or apartment ready for when you come home after surgery. Consider these items:
- Making sure stair handrails are secure
- Adding safety bars in the shower
- Having a stable chair at a height of 18-20 inches with a firm back, two arms, and a footstool for intermittent leg elevation
- A stable shower bench or chair for bathing
- Removing all throw rugs and loose carpeting
- A temporary recovery room on the ground floor, as walking up and down stairs will be very difficult in the early part of your recovery
What will my physical recovery be like?
In the hospital
You’ll likely stay in the hospital for a couple of days before heading home. We’ll get you moving your foot and ankle immediately following your surgery to increase blood flow in your leg muscles to help reduce swelling and decrease the chances of developing a blood clot. We’ll have you on a medication to prevent blood clot formation and decrease leg swelling. We may also use compression hose or even an inflatable leg covering.
You will begin physical therapy the day after your surgery. Your physical therapist will teach you the specific exercises you’ll need to strengthen your leg and restore knee movement. A continuous passive motion exercise machine could be used to help with this.
We will provide you with instructions for recovery when you return home a couple days after your surgery. You must follow these diligently, as this will largely dictate the successful return of full function in your new knee. These instructions will include wound care and bathing information.
Exercise is probably the most important part of your home care. Your activity regimen will include:
- A graduated walking program to slowly increase your mobility
- Resuming other normal household activities, such as climbing stairs
- Specific daily exercise plans that both restore movement and strengthen your knee. At first, you’ll have a physical therapist come to your home to help you with these.
- You should be able to resume most normal activities of daily living within 3-6 weeks of your surgery.
How long before I can drive after total knee replacement?
You may not have considered this, but the timeline for driving largely depends on which knee was replaced.
Patients who had their non-driving legs operated on may start driving once they are able to get in and out of a car comfortably. You’ll need to be off of any pain medication that could impact your driving skills.
Patients who had their driving legs operated on may drive as soon as 2 weeks after surgery or it may take up to 6 weeks or longer. How will you know?
- You’re not taking any pain medications that will impair your driving skills.
- You’ve regained pre-surgical reflexes and muscle strength.
How long before I can return to exercise after total knee replacement?
Your physical therapy will involve exercise, and that will start in some ways immediately after your surgery. Some patients also notice that after their knee replacement they are now more active than before their surgery. This is because their knee pain was slowly squeezing out more and more activity in their lives.
Resistance exercises usually can begin 4 to 6 weeks after your surgery. These will start with one- to two-pound weights. You’ll walk at 1 to 3 weeks, but you’ll use a walker. That will transition to crutches and then a cane. You will probably be able to walk on your own in 4 to 8 weeks.
Since “sports” are in our name at our practice, what about sports?
- Swimming, cycling, and golf can resume after the surgical wound is healed.
- Jogging, basketball, and volleyball are likely out, as they put pressure on your new knee and will cause it to wear out more quickly.
- Tennis should probably change to doubles only, and at a relaxed pace. Or consider switching to pickleball.
- Downhill skiing, skating, and sports where there is a risk of falling can be resumed, but the patient should have been proficient prior to their surgery, and you need to understand the risks.
Can you damage your knee again after having total knee replacement?
Yes. You can damage the prosthesis in a fall, and you can cause it to fail if you don’t show your new knee some respect. Failures will usually tell you with serious pain. This is especially true if the implant is coming loose.
Ramp up your activity and exercise gradually and odds are you and your new knee will enjoy a two-decade life together.
Contact Dr. Peter Holmes Today
Dr. Peter Holmes of Sports, Occupational and Knee Surgery along with his staff of professionals will ensure that you receive the right diagnosis for you and will follow you to assure your future good health and performance. We hope to be your practice of choice when undergoing a total knee replacement in San Antonio, TX.
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Schedule Your Consultation Today!
A healthy and happy body are only a click or call away. Call Sports, Occupational and Knee Surgery today for a knee replacement consultation at (210) 696-9000 at either our San Antonio or Shertz location.