Introduction to Artificial Joint Replacements

• Joint replacement means replacing the worn-out, painful joint surfaces of the knee with metal and plastic components.
• Utilized if biologic knee replacement fails.
• If only one part of the knee is worn, a partial (uni) knee replacement can be performed.
• Can last up to 20 years.

 Total Knee Replacement (TKR) Surgical Technique

• The goal of knee replacement surgery is the restoration of normal knee joint function.
• Incisions have become smaller with new minimally-invasive techniques.
• The upper (femur) and lower (tibia) bone surfaces are prepared and the prosthetic implants are placed.
• A plastic spacer is inserted and can be replaced to prolong the lifespan of the artificial joint.

Partial Knee Replacement (UNI) Surgical Technique

• When you wear out only one side of your knee joint, a partial knee device or unicondylar knee replacement is used. 
• Our goal is to minimize the loss of normal tissue and replace only the damaged area.
• The existing ligaments and muscles are maintained for stability and movement of the knee.
• The knee compartment is resurfaced, implants are placed, and the knee joint's range of motion is checked by bending and straightening your leg.

Options for Blood Transfusion

• Blood transfusions are sometimes used to restore blood volume after joint replacement.
• Red blood cells carry oxygen from the lungs to the rest of the body.
• A blood transfusion is usually given to increase the number of blood cells that are available to carry oxygen.
• There are several options available for your blood transfusion.
• Patients can choose to receive their own previously-donated blood, or blood from another donor.

Understanding Postoperative Pain Medications

• Unfortunately, pain following major surgery is inevitable.
• There are several very effective methods available to control the pain following surgery.
• Options include: intravenous injections, patient controlled analgesia (PCA), intramuscular injections, pills by mouth, and an epidural catheter, amongst others.

What Activities May I Participate In After I Recover from Knee Replacement Surgery?

• After undergoing knee replacement surgery, it is important to try to return to as active a lifestyle as possible.
• Most patients resume driving between 4-6 weeks.
• You are encouraged to climb stairs step over step immediately.
• Lower stress activities such as golfing, hiking, walking, biking, snow and waterskiing, stationary skiing, and swimming are encouraged.
• We take our patients’ pain very seriously and will do everything available to safely and effectively treat it.

Taking Care of Your Lungs After Total Joint Replacement

• Taking care of your lungs after surgery is an important part of the success of your surgery.
• It is important that your lungs are working at their best following surgery to ensure that you get plenty of oxygen to the tissues of the body that are trying to heal.
• Lungs that are not exercised properly can lead to poor blood oxygen levels and even develop pneumonia (an infection in the lungs) after surgery.

Preoperative TKR Physical Therapy

• A preoperative examination and preoperative treatment/intervention plan is created for each patient.
• A baseline of pain, functional abilities, strength, range of motion of each knee, and your breathing pattern is established.
• Any needs you have at home will be addressed.

Postoperative Unicompartment Rehabilitation Protocol

• Early emphasis is on achieving full extension equal to the opposite leg as soon as able.
• No passive or active flexion range of motion greater than 90 degrees for the first two weeks.
• No two-legged biking or flexion exercises for at least two weeks. Well-leg biking is fine.
• Regular manual treatment should be conducted to the patella and all incisions so they remain mobile.
• Early exercises should focus on recruitment of the vastus medialis obliquus (VMO).
• No resisted leg extension machines (isotonic or isokinetic) at any point in the rehab process.

Postoperative TKR Protocol

• Early emphasis is on achieving full extension equal to the opposite leg as soon as able.
• No passive or active flexion range of motion greater than 90 degrees until staples are removed.
• Regular manual treatment should be conducted to the patella and all incisions so they remain mobile.
• Early exercises should focus on recruitment of the vastus medialis obliquus (VMO).
• No resisted leg extension machines (isotonic or isokinetic) at any point in the rehab process.
• CPM (continuous passive motion machine) may be issued based upon doctor’s recommendation per case.

Potential Complications Following Knee Replacement Surgery

• As with all major surgical procedures, complications can occur.
• Some of the most common complications following knee replacement are:
• Thrombophlebitis
• Infection
• Stiffness
• Loosening

How Your Primary Care Physician and Your Orthopaedic Surgeon Work Together

• Before surgery, it is important that you arrange an appointment with your regular medical doctor
• An orthopaedic surgeon is an expert on the conditions that affect the bones, joints and muscles of your body.
• Your medical doctor is an expert on medical conditions, and knows a great deal about your individual medical needs during the preparation, hospitalization and postoperative recovery.

The Night Before Joint Replacement Surgery

• What to eat
• What medicines to take or avoid
• Other considerations

What to Expect During Your Hospital Stay