The knee is one of the largest, besides it also one of the most complex, vulnerable, and stressed-out parts of the body. It plays a vital role in bearing the weight of the upper body and also mitigates or absorbs the shock that goes upward through the feet during walking or running.
They also act as a smooth cushion for the thigh bones. Knee injuries are also one of the most common risk factors that millions face in day-to-day life. While people with minor injuries can recover from exercises or therapy, those with significant or chronic conditions may require knee replacement.
What Causes Knee Damage?
Sports falls, motor accidents, excess workouts, age, or certain health conditions such as arthritis are some of the common factors that may damage the knees. Obesity or malnutrition can also damage the knees.
Knee injuries vary depending on the exposure and the stress involved in it. Below listed are a few types of knee injuries.
- Fracture or breakage of the knee bones
- Inflammations or infections in knee pouches
- Tears in the knee joints or surrounding muscles
- Stretch or damage to the muscles or tendons protecting knees
- Dislocation of the knee that damages blood vessels, muscles, and nerves
Osteoarthritis and Rheumatoid arthritis are the two other common health conditions that affect the knees. Arthritis generally damages the cartilages that cover the ends of thigh and shin bones, which allows them to move with ease. Thereupon, the bones may rub against each other and become worn.
Sometimes overuse, weakness, or old age damages the cartilage under the kneecaps. It is often due to repetitive exposure to stress or ignoring any minor injuries.
Knee injuries can cause severe pain, stiffness, or inflammation. Due to that, simple tasks like walking, sitting, stretching, or bending knees can also become a daunting thing.
When to Go for Knee Replacement Surgery?
In general, if the condition is mild, doctors may suggest physical therapies, medications, exercises, or nutritional supplements that can alleviate the damage. In cases of obesity, doctors may also recommend reducing or cutting down the weight. However, when the problem is severe, knee replacement may become the only option.
Constant pain, problems with mobility, extreme stiffness, stiffness after inactivity, aches after inactivity or stress, chronic inflammation, or complete damage of the knee are some of the cases where the physician may suggest knee replacement surgery.
The surgery also depends on various factors, including health conditions such as underlying infections, the strength of the bones, and age.
According to research (1), timing is very crucial for getting knee surgery. An average functioning scale of the healthy knee is around 50. A person with knee problems may score about 32, and if that person gets the replacement, he may score up to 44. It is not normal but can help in improving the condition without disrupting daily life. However, if a person waits until chronic or acute knee problems, where they cannot bear the pain or disables their mobility, the surgery can only raise the score to around 32.
Types of Knee Replacement Surgery
Primarily, there are four types of knee replacement surgeries (2). They are as follows:
1. Total Knee Replacement
In this type of surgery, the surgeon usually replaces the joint surface at the top of the shin bone and end of the thigh bone. They may also repair and replace the under-surface of the kneecaps.
2. Partial Knee Replacement
It is an option when arthritis affects only one side of the knee and uses a technique called minimally invasive surgery. The person may recover faster and also have better functions. But, to undergo this surgery, the person must have strong knee ligaments.
3. Kneecap Replacement
In some conditions, only the under-surface of the kneecap and its groove may be affected, wherein they only get a replacement of the kneecaps. It is an option when arthritis or other infections do not progress or infect the areas outside of the kneecaps.
4. Complex or Revision Knee Replacement
It is for those who have already have had more than one or two replacement surgeries in the same knee. Fracture or significant bone loss, deformity of the knee, and weakness of the knee ligaments may also be reasons for this type of surgery.
Can You Avoid or Delay the Procedure of Knee Replacement Surgery?
Yes, as mentioned above, if the injuries or the damage is minimal, then one can delay or avoid the process of knee replacement. Even most doctors take this approach before knee replacement surgery. Below listed are a few alternates that doctors may offer before going for surgery.
1. Weight Loss
Obesity or overweight is one of the most common causes of wear & tear and other knee injuries. Cutting down overall body weight can reduce the excess pounds around knees and also reduce the stress or strain it receives from the upper body.
2. Mitigating the Effects of Injuries
In some cases, minor injuries or repeated strain over a long-period of type can cause chronic knee problems. Here, if you visit a doctor in the early stages of injuries, they may help you reduce the burden with some stretching techniques or suggest you use protective guards while working out or doing any physical activity.
To avoid any injuries while playing, you must always wear shoes and other protective equipment concerning sports.
3. Supplements or Medications
Some supplements can also help in relieving the pain & stiffness and also reduce the progression of the disease. However, to get the optimum benefit, the person should also follow a healthy dietary and exercise regimen.
Especially anti-inflammatory medications and can help the person to relieve pain or alleviate the inflammation in the knees. The physician may also suggest injections that may reduce pain and inflammation.
4. Assistive Devices
Wearing assistive devices in the early stage of injuries or damage can help in faster recovery from it naturally. Here, alongside using the methods, the doctor may also suggest certain medications to support the recovery process or help the body heal the damaged knees from inside.
5. Physical Therapy
A physical therapist can help reduce the stiffness, pain, and inflammation in joints. They do so by strengthening the muscles, bones, through appropriate exercises and massages.
How Long Does a Knee Replacement Last?
According to a study (3), a knee replacement lasted for around 15-20 years in 90% of the patients. Note that after that duration, the wear and tear may reduce the effectiveness of implants. During that condition, the person may experience various symptoms, including pain, infections, instability in knees or legs.
If you have any troubling issue with the knee replacement, you must consult your physician immediately to fix it before it gets complicated.
How Is a Knee Replacement Done?
Preparing for a knee replacement surgery is of utmost importance. You should get a complete health check-up and make sure that your general health is good and can support the operation. In case, if you have any health complications such as blood pressure or diabetes, the doctor may take some measures to improve the condition or follow some procedures that may help your body support the surgery.
You will also have to check for any possible infections that may affect your body or get into the bloodstream. Also, the surgeon may suggest specific exercises or therapies that may strengthen the muscles, which in turn can improve the time of recovery. The other important thing that you should check with your surgeon is about any current medications or treatments that you are taking.
The knee replacement surgery depends on the intensity of damage or injury, as mentioned above. In either case, the worn ends of the knees are removed and then replaced with plastic parts or metals.
In a total knee replacement surgery, the surgeon removes the damaged ends of the thigh and shin bones. While in partial, only the small damaged parts are cut and replaced.
After the surgery, you may stay in the hospital for a couple of days, where you may be under the observation. A full knee replacement recovery time is generally around 4 to 6 months or a year in some cases of total knee surgery. However, most will be able to resume regular activities within six weeks.
Knee Replacement Recovery
The recovery after knee surgery depends on various factors, including age, general health, the strength of muscles, the condition of the bones, blood vessels, nervous system, and tissues surrounding the bones.
After the surgery, doctors advise some precautionary measures to ease the complexities involved with it.
The person who underwent surgery may experience stiffness. To ease it, doctors may suggest some light exercises or physical therapies that can reduce stiffness and enhance flexibility.
2. Pain or Inflammation
It is a typical experience after surgery, either due to bruising or sudden change in the condition of your knees. Doctors may suggest some painkillers to alleviate the pain. Even exercise can help reduce it.
In some cases, the person may suffer from it. Surgeons advise precautions that you must follow to avoid any such infections. If you feel that you have any signs of it, you must immediately bring it to the doctor’s notice.
Other Precautionary Measures to Follow After Knee Surgery:
- Talk to your physician and get a proper routine of exercises to strengthen and enrich the mobility of the knees.
- Take extra precautions to avoid any damage to the knees, either from falls, injuries, or excess strain from exercises, walking, or even daily chores.
- Get a proper prescription of antibiotics and other medications that can inhibit infections and improve the condition of your knees and muscles.
- Get a regular check-up with your doctor at least once or twice in a year with x-rays and other required examinations.
- Avoid any foods or lifestyle habits that may trigger infections, inflammation, or any conditions that may complicate the recovery process. You can check with your doctor to get a list of things to avoid.
Knee Replacement Exercise
As mentioned above, exercises play a vital role in speeding up the recovery process. They help in improving the blood flow, preventing blood clots, stiffness, and inflammations in the knees and feet. Below listed are a few such physical workouts that one can follow following the doctor’s recommendation.
It helps in improving the mobility of the legs. The doctor may suggest walking sticks or crutches as the bones, muscles, and other tissues in the legs may become weak after the surgery. The duration of using the sticks depends on the type of surgery, weight, and coping abilities of the body. After a few weeks or months, depending on the recovery, the doctor may suggest you quit using the sticks slowly.
Later, you can walk up without using the sticks, but do not try to run or walk for long distances.
2. Sitting and Kneeling
Once the legs heal and you feel the difference, you can start kneeling or sitting with knees bent. But do not sit cross-legged in the initial stages. It may be uncomfortable in the beginning, but you will experience the difference after a few days or weeks.
3. Ankle Push or Pump
Rest and place your leg straight on the floor. Push your feet towards you and then pull it away from you. You can also rotate the feet in a clockwise and anticlockwise direction.
Sit on a chair and gently swing your knee in the forward and backward motions. Swing only to a length where you feel a slight stretch and do not put any pressure wherein it may stress the knees.
Rest on the floor with your legs straight. Gently slide the knees towards you, using your heels.
Rest on the floor and slowly slide your legs to the side.
Lay on your back and put a small pillow or a rolled towel under the knees. Slowly, lift your legs and hold it for five seconds and rest them back. You can repeat this for five to minutes.
If you are feeling any pain during these exercises, you can rest and put some cold or ice packs to ease the pain. Make sure to put a dry and clean cloth between the ice pack and the skin.
You can practice these exercises for 30-45 minutes in a day in the initial stages and later increase the duration.
Make sure that you check with your surgeon about these exercises before practicing them.
8. Physical Therapy
After a few days or weeks from the surgery, the doctor may suggest some physical therapy that can strengthen the muscles and bones. It can help in easing the stress as well as enriching the recovery process.
Things to avoid in the first few weeks or until the doctor suggests:
- Do not drive vehicle
- Do not lift excess weights
- Do not indulge in high-intensity workouts
If you experience any severe pain, inflammation, wounds with pus or sores, consult the doctor immediately.
Following these precautions and the doctor’s recommendations, you can experience the normality of the knees within a few weeks.
Risks and Complications of Total Knee Replacement Surgery
In general, following the precautions can reduce any complications. However, in rare cases, there may be some negative side-effects associated with the surgery. Below listed are a few:
- Blood clots
- Persistent pain
- Reduced mobility
- Problems with wound healing
- Muscle or neurological injury
Even in such cases, following a healthy lifestyle regimen recommended by the surgeon can mitigate those complications.
Knee replacement surgery is a wise-option to avoid any adversities that may be associated with prolonged & chronic stress or severe damage to the knees. Even though it cannot bring the knees back to a natural condition, it can be very close to the healthy function. However, you have to make sure to follow the precautions to optimize the results.
Also, make sure to consult your doctor before you adopt any foods or physical workouts that you may think could cause complications.
1. Is a partial knee replacement worth it?
Yes, partial knee replacements can help in recovering from injuries to some parts of the knees. It can also inhibit the progression of any early-stage damages, fractures, or infections.
2. What are the symptoms of wrong size knee replacement?
Yes, wrong size knee replacements or failed knee surgeries can exhibit various visible symptoms. They include severe pain, swelling, stiffness, and restricted motion even after a few days or weeks.