When faced with pain from a knee joint that now has bone rubbing on bone, you may need a knee joint replacement. McLeod Orthopedic Specialist Thomas DiStefano, MD, outlines the process and promise of treating a knee gone bad:
Here are the main points of DR. DiStefano’s comments:
Generally, a person needs a knee joint replacement when: 1) they’ve lost all the cartilage in their knee, causing a loss of their ability to do activities of daily living; 2) they’ve lost their quality of life; and 3) they’ve pursued all conservative treatment. Surgery is a last resort treatment.
Conservative treatment includes physical therapy, exercises, losing weight, cortisone injections, hyaluronic acid injections and anti-inflammatory medication. When all of those have failed and the person’s quality of life is still being restricted (not able to do the things that they want and their X-rays show significant arthritic changes), we start considering knee joint replacement.
Physical therapy and exercises before the surgery are critical to the success of the recovery for knee replacement patients. Many patients have a lot of pain for a long time and are really deconditioned leading up to surgery. It’s very helpful to get them involved in physical therapy preoperatively so that they can work on their range of motion, strength, and endurance to speed their recovery afterward.
Depending on their family support and physical condition going into surgery, most patients go home the same or next day. Generally, we try to get them home within a day and set up physical therapy with the therapist coming to their house. Some people visit an outpatient therapy facility. A few patients need a stay at an inpatient rehabilitation facility.
Typically, people either use a walker or crutches for 2-4 weeks after surgery. It takes about 6 months to get about 85% capability and a year to get to complete recovery.
We use a computer navigated program to create custom cutting blocks for each patient. We still do the surgery the same way. But doing surgery with the custom fitting allows us to place the components more precisely. And we feel that really helps the patient’s outcome and recovery.