Expert Orthopedic Care Awaits

Before you consider surgery, your doctor will usually encourage you to try various nonsurgical treatments, which may include:

• physical therapy
• weight loss (if appropriate)
• anti-inflammatory medication
• steroid injections
• hyaluronic (gel) injections
• alternative treatments such as acupuncture

In some cases, these solutions may help manage knee problems. But if the symptoms worsen and start to affect your quality of life, surgery may be the best option. Delaying or avoiding surgery for a long time can make things worse.

Ask yourself questions such as:

• Have I tried everything?
• Is my knee preventing me from doing the things I enjoy?
• Will a knee replacement improve my quality of life?

The surgeon makes an incision over the front of your knee to expose the damaged area of your joint. They move your kneecap to the side and cut away the damaged cartilage and a small amount of bone.

Then, they replace the damaged tissue with new metal and plastic components. The components combine to form an artificial joint that is biologically compatible and mimics the movement of your natural knee.

Most knee replacement procedures take 1 to 2 hours to complete.

Artificial knee implants consist of two metal components, on that goes over the thigh bone/Femur called a femoral prosthesis or a ‘femur cap’ and the other sits on the top of the leg bone/tibia, called the tibial tray and a medical-grade plastic called High molecular Weight Polyethylene(HMWP), which slips and fits perfectly between these two metal components. The metal components are fixed to the bony parts with medical grade cement.

Any operation that involves anesthesia has risks, but severe complications are rare.

If you’re having a total knee replacement, your options are:

• general anesthesia
• spinal or epidural anesthesia
• a regional nerve block

An anesthesia team will decide on the most suitable options for you, but most knee replacement procedures involve a combination of the above methods.

You’ll definitely experience some pain after your operation, but your surgical team will do everything possible to keep it manageable and minimal.

You might receive a nerve block before your operation, and your surgeon might use a long-acting local anesthetic during the procedure to help with pain relief after the procedure. Your doctor will also prescribe pain medication.

Once you recover from surgery, and have completed your physiotherapy regimen, your knee should be significantly less painful than it was before.

If you received a general anesthetic, you might wake up feeling a bit confused and drowsy. You’ll probably wake up with your knee raised (elevated) to help with swelling.

To reduce your risk of developing a blood clot, you may need anticoagulant medication (blood thinners), foot/calf pumps, or both.

Many people have an upset stomach after surgery. This isn’t anything to worry about, and your healthcare team may provide medication to ease the discomfort.

Your doctor will also prescribe intravenous (IV) antibiotics to reduce your risk of infection. Antibiotics can help prevent infections, but it’s important to be able to recognize the signs of an infection in case one occurs after knee surgery.

Most people are up and walking within 24 hours with the help of a walker or crutches.

After your operation, a physical therapist will help you bend and straighten your knee, get out of bed, and ultimately learn to walk with your new knee. This often happens on the same day as your operation.

Most people are discharged from the hospital the same day or the morning after surgery.

Once you return home, you’ll continue to have therapy regularly for several weeks. You’ll perform specific exercises that aim to improve the functionality of the knee.

If your condition requires it, or if you don’t have the support you need at home, your doctor might recommend that you spend time at a rehabilitation or nursing facility first.

Most people recover within 3 months, although it may take 6 months or longer for some people to recover fully.

If you live in a multiple-story house, prepare a bed and space on the first floor so you can avoid the stairs when you first come home, if possible.

Make sure your home is free of obstructions and hazards, including power cords, area rugs, clutter, and unnecessary furniture. Focus on pathways, hallways, and other places you are likely to walk through.

Make sure that:

• handrails are secure
• a grab bar is installed in the tub or shower
• a bath or shower seat is available

Most people need an assistive device (a walker, crutches, or a cane) for about 3 weeks after knee replacement surgery, although this varies significantly from person to person.

You’ll be able to do low impact exercise such as riding a stationary bike, walking, and swimming after 6–8 weeks. It’s important to make sure your incision has fully healed before swimming.

Your physical therapist can advise you on introducing new activities during this time. You should avoid running, jumping, and other high impact activities immediately after surgery.

You can contact your orthopedic surgeon with any questions you have about your activities.

According to a 2019 research review, more than 82% of total knee replacements are still functioning 25 years later. But wear and tear can negatively affect the performance and life span of an artificial knee.

Younger people are more likely to need another knee surgery at some point in their lifetime, mainly as a result of having a more active lifestyle. You can consult a doctor about your specific situation.

Apart from this, various types of knee prosthesis are available today with varying lifespans and varied types of coating, making them resist wear and last longer, which you can discuss with your surgeon.

Platelet-rich plasma (PRP) therapy is a treatment that uses your own blood to treat damaged tissues. It may help reduce pain from osteoarthritis, but more research is needed.

Injections of platelet-rich plasma (PRP) are a novel treatment for managing pain related to osteoarthritis of the knee.

Some PRP preparations have approval from the Food and Drug Administration (FDA), but approval does not yet cover the use of PRP in osteoarthritis of the knee. Nevertheless, some clinics may offer PRP “off-label.”

With further research, however, PRP may become a useful treatment option for osteoarthritis of the knee.

PRP therapy for osteoarthritis of the knee works by injecting platelet-rich blood into the area surrounding your knee to help reverse existing tissue damage.

Your blood is comprised of four components. Most of your blood is liquid, known as plasma. The other three components are platelets, white blood cells, and red blood cells.

Platelets play a key role in the clotting of your blood. They also contain growth factors that could help tissues repair themselves by causing new cells to form, according to the American Academy of Orthopaedic Surgeons (AAOS).

Some research suggests that PRP may be an effective treatment for knee osteoarthritis. For example:

• A 2022 Study of 153 participants found that after a 6-month follow-up, PRP helped improve symptoms of pain and stiffness, mobility and function, and quality of life.
• A 2021 study of 118 participants found that after an average of 51.7-month follow-up, PRP helped improve symptoms of knee osteoarthritis.
• A 2020 review found that after 3-, 6-, and 12-month follow-ups, PRP was a more effective treatment than steroids, hyaluronic acid, and placebos.
• A 2017 study found that after 3-, 6-, and 12-month follow-ups, PRP helped reduce pain and improve physical function compared to placebos.

Despite the positive outlook, other studies have found conflicting results for using PRP as a treatment for knee osteoarthritis. For instance, a 2019 review noted that some studies support using PRP for knee osteoarthritis but others say it has no effect.

PRP therapy is a three-step process:

1. A doctor will draw a small amount of blood from your arm.
2. They’ll put the blood sample into a centrifuge to separate the components and obtain a concentrated suspension of platelets in plasma.
3. A doctor will numb your knee and inject the PRP into the joint space in the knee. 
4. After resting, you will be able to go home. You should arrange for someone to drive you home, as there may be pain and stiffness after the injection.

There’s no consensus among research as to how long the effects of PRP injections last for knee osteoarthritis. A 2022 review found some studies report benefits from PRP therapy up to 12 months after the injection, but one study found no more benefits after 24 months.