total knee replacement

Hundreds of thousands of knee replacement surgeries are performed in the U.S. each year. Knee replacement specialist and orthopaedic surgeon Steven Zelicof, M.D., Ph.D.,  answers our questions about the procedure and what to expect.

What is total knee replacement?

A knee replacement is actually not a replacement at all but rather a resurfacing of your worn out knee, to lessen your pain and improve your mobility. Your doctor carefully identifies the area of your knee that has worn away due to arthritis. The bone is then carefully shaped and a metal cap is placed on top of the thigh bone (femur) and shin bone (tibia). A plastic insert is placed between the metal implants, replacing your missing cushion (cartilage). The under surface of your knee cap (patella) may also be resurfaced if it is worn away.

Who is a candidate for total knee replacement?

You are a candidate for knee replacement when your knees keep you from doing things you normally enjoy and non-surgical treatment options have failed. The most common misconception is that “I am too young (or too old) to have surgery.” Age is not an indicator for surgery. Rather, your overall health and level of activity is more important. Most knee replacements are done under regional anesthesia, such as a spinal or epidural. You do not need general anesthesia, making for a safer surgery safer and better pain control.

How long do knee replacements last?

Contemporary knee replacements can last over 20 years. However, your health, activity and weight all contribute to the longevity and success of your new knees.

What are some non-surgical options for treating knee arthritis?              

To successfully treat your knee pain, see a doctor to identify the cause and severity of your arthritis, which is a wearing away of the surface and cushion in your knee. Arthritis can often be treated with a combination of exercises to strengthen the muscles around the knee, along with weight loss. Knee braces often provide comfort as well. Medications such as acetaminophen (Tylenol) and anti-inflammatories can also help. However, all medications should be used sparingly and under the advice of a physician as they have side-effects. Nutritional supplements such as glucosamine and chondroitin are popular but do not have proven benefit over placebo or sugar pills.

Knee injections using cortisone or hyaluronic injections can also provide temporary relief. The benefits can last up to six months or longer and the shots can be repeated.

What are some advancements in knee replacement surgery?

Knee replacement surgeries have become less painful with improved muscle sparing approaches as well as the addition of new pain management techniques. Most patients are out of bed, walking the same day and may go home within two to three days. The procedures have become more precise with the use of computer navigation and robotic techniques. Patients can often drive and return to their normal activities, including sports, within two to three weeks after surgery.

How to I pick an orthopedic surgeon to evaluate and treat my knee?

Practice makes perfect! Pick a surgeon specializing in knee replacement surgery who performs many  procedures per year (more than 200). You are establishing a long-term relationship with your surgeon; ask about their track record and make sure you are comfortable with him or her! Additionally, pick a hospital with a comprehensive team and proven record of success in joint replacement surgery.

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