Should I Have a Total Knee Replacement? Answers from a Vail Orthopedic surgeon

May 25

Q&A: The Total Knee Replacement Procedure, Recovery, and Physical Therapy

When considering performing a Total Knee Arthoplasty (TKA), our first priority is to attempt to minimize the arthritis of the knee via non-operative treatments or lifestyle adjustments. This will certainly entail some type of lifestyle change, at least in the short term. We take into consideration the following methods:

Introducing an appropriate exercise regimine
Injections or medication
Bracing
Weight loss strategies

Of course, if you are considering a TKA, chances are that you are having advanced arthritis of the joint, and possibly experiencing uncomfortable levels of pain. An x-ray will tell us what we are dealing with.

WHAT SHOULD YOU TAKE INTO ACCOUNT BEFORE HAVING A TKA?

A TKA is a major decision, so the choice to have your knee replaced should be discussed at length with your surgeon. Measuring your levels of pain and activity scores, we can make an informed decision about whether it's realistic to lead the lifestyle you want to live and continue to participate in your chosen activities.

Click here to read about Activity Preservation

As I've mentioned before, we're now focusing on "Activity Preservation" as one of our primary tools to evaluate treatment. This includes total knee replacements. If non-operative treatments have failed when it comes to allowing you to live your preferred lifestyle when it comes to activities, then it's time to consider a TKA.

Click here to read about the Tegner Activity Score

HOW LONG DOES A TOTAL KNEE REPLACEMENT LAST?

Good news here, a total knee replacement can last fifteen to twenty years. Annual failure rates point to a percentage between .5% and 1% for hip and knee replacements.

WILL I BE SLOWED DOWN AFTER MY TKR?

Initially, yes. However, you should be able to do most activities after your recovery, although running and jumping may be restricted. There are some restrictions to your activities for several weeks post-surgery, and your surgeon will discuss those with you before and after your knee replacement.

POSSIBLE COMPLICATIONS OF A TOTAL KNEE REPLACEMENT

As with any major surgical procedure, there are the chances of complications. These include the following:

Increased joint stiffness.
A loss of motion in the joint.
An infection requiring antibiotics and the possibility of additional surgery to eliminate the infection completely
Failure of implants due to long term wear and tear
Life-threatening complications
Swelling

HOW LONG WITH MY HOSPITAL STAY BE?

The answer to this question is going to be influenced by your age, health, and medical situation pre-surgery. Usually, we see people staying in the hospital from one to three days, depending on circumstances.

WHEN CAN I WALK AFTER MY KNEE REPLACEMENT?

We know you're probably excited to go back to your regular life, so we try to get you walking as soon as possible. With the assistance of a walker, most people are mobile right after surgery, and walking with a cane or unassisted by three weeks out.

IS A TOTAL KNEE REPLACEMENT PAINFUL?

The level of pain people experience after this procedure is really going to vary. We have some very talented people who are devoted to helping you develop your range of motion quickly post-surgery. These devoted therapists are also well-schooled in protocols to lessen stiffness and pain dramatically. It all comes down to your body, but we certainly have plenty of people who merely experience mild pain after the procedure.

HOW LONG DOES IT TAKE TO RECOVER?

It can take up to three months for you to return to most activities. For a total recovery, we expect six months to one year to achieve maximum strength and endurance following a TKR. This depends on your condition before surgery, additional medical problems, and your expectations.

WILL I NEED PHYSICAL THERAPY? FOR HOW LONG?

Most people who have undergone TKR require outpatient physical therapy following surgery. A skilled therapist can accelerate the rehabilitation as well as make the process more efficient with the use of dedicated machines and therapeutic modalities. Depending on your condition before surgery, physical therapy is beneficial for up to three months. The amount of therapy needed depends upon your condition before surgery, motivation, and general health.

WHEN CAN I GET BACK TO WORK AFTER A TKR?

You should definitely plan for an extended break after you TKR. If your job is a "sitting" job such as spending lots of time at the computer, we are looking at six to eight weeks before you return to work. For you folks who have jobs with a high level of physical requirements, it could be up to three months before you are fully back in the saddle.

SHOULD I CONTINUE TO SEE MY SURGEON AFTER I’M HEALED FROM MY KNEE REPLACEMENT?

You definitely want to stay in close contact with your orthopedic surgeon after your procedure. We want to make sure to monitor your joint replacement as you continue to pursue a lifestyle that is enjoyable and pain-free.

As you've heard before, every case is different, and your physician will carefully consider a program to monitor your joint. It is reasonable to expect to see your surgeon every three to five years.

Hope that helps!

Dr. Sterett

Dr. William Sterett, M.D.

Dr. Bill Sterett is the Head Team Physician for the US Women’s Alpine Ski Team and has been since 1997, with athletes over the years such as Picabo Street, Kristina Koznick, Caroline LaLive, Julia Mancuso and Mikaela Shiffrin. He has served as a US Olympic Committee Team Physician for the past four Winter Olympic Games, with the US Olympic Committee entrusting the care of their athletes to Dr. Sterett in Salt Lake City, Torino, Vancouver and Sochi.

Dr. Sterett is Board Certified by the American Board of Orthopaedic Surgery, a member of the American Orthopaedic Society for Sports Medicine, a member of the Arthroscopy Association of North America, and is one of the few physicians who have earned a Certificate of Added Qualification in Sports Medicine.

Dr. Sterett has published more than 30 peer-reviewed articles and has lectured regionally, nationally and internationally on hundreds of occasions over the past twenty years. He currently holds patents on orthopedic devices involved in Joint Preservation and works as a consultant to Arthrex and Biomet sports medicine companies.

Dr. Sterett started the Athletic Training Fellowship Program in Vail, Colorado, and served as its Fellowship Director for 15 years. Additionally, he has served as the Medical Director for the Eagle County School District for 14 years, making daily return-to-play decisions and treating local student athletes. Currently, he serves as the Medical Director for the Vail Valley Surgery Centers and has for the past 12 years.

http://www.drsterett.com