Deciding whether or not to get total knee replacement surgery is a difficult decision. Discussing your treatment options with your doctor is essential to helping you decide if this is the right choice for you. Learn more about total knee replacement surgery to help formulate some questions to ask your doctor. Remember to write these questions down and bring them to your next appointment.
Early diagnosis and treatment of osteoarthritis are important for your long-term mobility. In fact, having knee replacement surgery earlier in the course of the disease may be linked with better outcomes. So if your doctor has recommended that you undergo a knee replacement, don’t delay. Postponing surgery can lower your quality of life, both before and after surgery. Remember, there is no cure for osteoarthritis. It is a degenerative disease, which means that your condition will get worse over time if left untreated.
Each patient recovers differently. After surgery, you will work with a physical therapist to gradually increase your knee strength and mobility. You may experience some pain during physical therapy. The good news is that medications can help you manage this pain, and it should improve strength and motion, which will help reduce stiffness in your knee.
Many patients find that the pain after surgery is tolerable, treatable and subsides gradually over a few months. Surgeons and hospital staff have a variety of options to manage pain and keep patients comfortable after surgery, such as numbing injections, IV pain medication, patient-controlled anesthesia, injections, pain pills and anti-inflammatory medications.
The typical hospital stay is 2 to 6 days.
There are two common types of anesthesia used during knee replacement surgery: general anesthesia where the patient is put to sleep; and regional anesthesia, where the patient is numbed below the waist, typically with an epidural or femoral/sciatic nerve block. Which type of anesthesia you will receive depends on your condition, as well as your surgeon's and anesthesiologist's recommendations. Speak with your surgeon or anesthesiologist if you have any concerns regarding the anesthesia that will be used during surgery.
Many people are able to go home soon after surgery. Others choose to recover at a rehabilitation center. This decision depends on the availability of family or friends to help you with daily activities; your home environment and safety considerations; and your overall evaluation after surgery. Your surgeon and you will decide together which course of treatment is best for you. You may want to check in advance with your insurance carrier to see whether you have medical coverage for a rehabilitation facility and for how long.
Talk with your surgeon to determine what’s best for you. Many patients are able to drive again in about 4 to 6 weeks, so long as you can tolerate it and are not taking narcotic medications. If your job is not physically demanding, you may be able to return to work after about a month.
There is no clinical evidence to support the need for a gender-specific knee implant, nor is there any clinical data on the long-term success of a gender-specific knee. Today, more than 60% of all current knee replacements are implanted in women, with a 90% to 95% rate of satisfaction.
Regardless of whether you are a woman or a man, everyone’s anatomy is a little different. DePuy’s TRUMATCH® Personalized Solutions uses a three-dimensional computerized scan of your leg to create customized surgical guides that are designed to deliver a personalized solution based on your unique anatomy. Ask your surgeon what he or she is doing to tailor your total knee replacement to your anatomy.
Many patients believe that the knee joint acts as a hinge, which can only bend and straighten like a door. In reality, the knee is much more complex because the surfaces roll and glide against each other as the knee bends. For women, rotation is a particularly important consideration, as women’s knees rotate more than men’s during deep knee bending. So rotation is a key factor in the way your knee functions.
There are some early studies of minimally invasive surgery (MIS) that have shown benefits such as less blood loss, shorter hospital stays, and better motion. Other studies, however, have shown more complications, poor implant positioning, and no difference in the length of recovery. Because MIS is still relatively new, it won't be known for 10 to 15 years if these new techniques affect the long-term function and durability of the implant. You should discuss with your surgeon whether MIS is an appropriate surgical course of treatment for you.
The success of your knee replacement is measured by whether or not you're satisfied with the decrease in pain and the increase in mobility you should have, as well as the durability of your implant over time. Knee replacement in general is a very successful operation. In fact, according to an Arthritis Foundation study, outcomes for total knee replacement generally have 90% to 95% patient satisfaction and an implant lifespan greater than 95% at 10 and 15 years with some designs.
The cost of a total knee replacement surgery depends on your individual needs, but typically costs from a few thousand to several thousand dollars, plus orthopaedic surgeon fees and the cost of your hospital stay. Keep in mind that the cost for a total knee replacement can be about half the cost of a total knee replacement. However, most insurance companies as well as Medicare and Medicaid cover knee replacement surgery. You should contact your insurance provider to see whether knee replacement is covered under your plan.
Knee replacement surgery is considered medically necessary and is typically covered by both private insurance and Medicare. Your out-of-pocket expenses may be impacted by either your co-pay or deductible, so you should check with your insurance company or your state Medicare office for complete information.
Several weeks before you undergo total knee replacement surgery, discuss your recovery with your surgeon and caregiver(s). Speak with your family members and/or friends about the role they will play in your recovery. Explain the recovery process to them and the care you will need after surgery.
The way a knee replacement will perform depends on your age, weight, activity level and other factors. There are potential risks and recovery takes time. If you have conditions that limit rehabilitation you should not have this surgery. Only an orthopaedic surgeon can tell you if knee replacement is right for you.