Marcus Greatens, M.D.
Orthopedic Surgery, Orthopedics
Is it time for a total knee replacement?
Climbing stairs has become an ordeal. Taking the dog for a long walk is out of the question. Squatting to pick up a grandchild just doesn't happen anymore. When you're not able to do the things you want — and love — to do, your body may be telling you it's time for a total knee replacement.
A total knee replacement is a major surgery that requires a big commitment on your end to recover from it. For the first three months after surgery, you'll be healing and doing exercises to build strength and improve your range of motion. Full recovery from a total knee replacement takes a up to a year.
Before you and your orthopedic specialist decide it's time, you'll want to give noninvasive therapies a chance, including:
- Modifying your activities.
- Taking pain relievers, such as acetaminophen.
- Bracing your damaged knee.
- Undergoing cortisone injections.
- Using a cane or walker.
- Working with a physical therapist.
There's no age range for having a total knee replacement. It's a matter of decreasing function and increasing pain that matches up with what X-rays of your knee are showing. For instance, if you're 50, have bad arthritis and are unhappy with your quality of life, then it's reasonable to undergo a total knee replacement to regain function and mobility at a younger age.
When you decide you're ready, and you've "checked all the boxes" for appropriate noninvasive therapies, then it's time to plan for a total knee replacement. Since this is most commonly an elective surgery, you can time it to fit your work and home calendars for when you'll have a three-month stretch to devote to recovery.
You'll also consult with an orthopedic surgeon and begin preparing for surgery by:
- Undergoing a physical check up and any needed tests.
- Ensuring your diabetes is under control, if applicable.
- Losing weight or stopping smoking, if recommended.
- Working with a physical therapist on a series of muscle-strengthening exercise so your leg is as strong as possible going into surgery.
- Consulting with an occupational therapist to learn what adjustments and aids may make your recovery at home safer and easier.
- Arranging for someone to care for you when you get home.
- Undergoing imaging so your surgeon has the latest picture of your knee.
Depending on a number of factors, you may be a good candidate for same-day surgery. Be sure to discuss this option with your surgeon. Otherwise, expect to spend one or more nights in the hospital.
The goal of a total knee replacement is to get back to the activities you've been missing and live the life you want to live without pain or restrictions. You'll know when it's time.
Marcus Greatens, M.D., is an orthopedic surgeon in Eau Claire, Wisconsin.