A total knee replacement or knee arthroplasty is a full or partial resurfacing of the closest bones to the knee joint. This is the bottom of the femur and the top of the tibia (shin) bone. The surgery applies a metal shell to the femur, a metal plate to the shin bone, and a plastic “spacer” between these two surfaces.
Occasionally they will replace the surface behind the kneecap, however, this will depend on the nature and severity of the diagnosis.
This surgery is most common with advanced arthritis (Osteoarthritis/Rheumatoid), trauma, or reduced function with pain. Symptoms leading up to this may include pain, achiness, and joint stiffness.
As can be seen in the image, the surgery aims to replace the areas where the cartilage, or the natural cushion between the bones, has worn down. Without this rubbery cushion, it is harder for the bones to glide smoothly through movement and may result in what doctors refer to as “bone on bone”
Should I have a total knee replacement?
Before rushing to get under the knife and have a total knee replacement surgery, conservative management with physiotherapy should always be attempted.
A combination of physiotherapy techniques, such as hands-on release, exercise prescription, and advice on modifying activities, may give you relief from your knee pain to be able to delay or skip the surgery altogether.
As with all surgeries, there is always a degree of risk with invasive procedures such as a total knee replacement. Complications can include infection, ongoing instability, and knee pain.
Some view a total knee replacement as an immediate fix to knee pain, however, this is unfortunately not the case. After a total knee replacement surgery, there will be quite a large amount of discomfort from both the incision sites and the inserted prosthetic. There is also an extensive amount of rehab required after a total knee replacement.
Careful consideration of all factors should be evaluated for surgery, including the risk vs benefit of the surgery.
What should I do before having a total knee placement?
Before undergoing a joint replacement, research has shown that strengthening the surrounding muscles can result in greater outcomes postoperatively, such as less pain and greater movement.
As physiotherapists, we treat many people before they have surgery, we call this “prehab”. During total knee replacement prehab, we will focus on strengthening the quadricep muscles, muscles around the hips as well as managing the pain while you await surgery.
Preparing your home environment to ensure a safe and easy return home from the hospital is vital. Equipment such as toilet frames and bathroom rails should be considered to assist with easy living. If you live in a house that requires a large amount of stair climbing this can be quite difficult initially. Having a make-shift bedroom on the lower levels or staying in other accommodation without stairs may have to be considered. Social support from family and friends to assist with cooking and cleaning will help immensely.
What happens after a total knee placement?
After surgery, you will spend anywhere from 3-7 days in the hospital to get you back on your feet and able to return home. Once returning home you should book an appointment with one of our physiotherapists at iMove as soon as possible.
We will help assist you with a rehabilitation program focused on restoring the range of motion in your knee, strength exercises, and getting you back to the things you love doing. This process may take approximately 6 months depending on individual factors.
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