Frequently Asked Questions about Knee Surgery
Below is a list of the most frequently asked questions along with their answers. You can also find this information and more, in the Sacred Heart Medical Center Orthopedic Patient Handbook. If you have any other questions that you need answered, please ask your surgeon or the care team.
What is arthritis and why does my knee hurt?
In the knee joint, there is a layer of smooth cartilage on the lower end of the femur (thighbone), the upper end of the tibia (shinbone) and the undersurface of the kneecap (patella). This cartilage serves as a cushion and allows for smooth motion of the knee. Arthritis is a wearing away of this smooth cartilage. Eventually it wears down the bone. Rubbing of bone against bone causes discomfort, swelling and stiffness.
What are my knee replacement options?
A total knee replacement is really a cartilage replacement with an artificial surface. An artificial substitute for the cartilage is inserted on the end of the bones. This creates a new smooth cushion and a functioning joint that does not hurt.
Sometimes your surgeon determines that only part of the cartilage needs to be replaced. These are called unicondylar replacements or patella-femoral replacements.
How successful are total knee replacements?
90-95 percent of patients achieve good to excellent results with relief of discomfort and significantly increased activity and mobility.
When should I have this type of surgery?
Your orthopedic surgeon will decide if you are a candidate for the surgery. This will be based on your history, exam, x-rays and response to conservative treatment. The decision will then be yours.
Am I too old for this surgery?
Age is not a problem if you are in reasonable health and have the desire to continue living a productive, active life. You may be asked to see your personal physician for his/her opinion about your general health and readiness for surgery.
How long will my new knee last, and can a second replacement be done?
We expect most knees to last more than 10-20 years. However, there is no guarantee, and 10-20 percent may not last that long. A second replacement may be necessary.
Why do knee replacements fail?
The most common reason for failure is loosening of the artificial surface from the bone.
What are the major risks?
Most surgeries go well, without any complications. Infection and blood clots are two serious complications that concern us the most. To avoid these complications, we use antibiotics and blood thinners. We also take special precautions in the operating room to reduce risk of infections. The chances of this happening in your lifetime are one percent or less.
Will the surgery be painful?
You will have discomfort following the surgery, but we will keep you comfortable with appropriate medication. The care team will monitor your level of discomfort frequently and treat you as ordered by your surgeon. We will discuss what pain interventions have worked for you in the past, and work with your surgeon to develop an individualized pain management plan.
How long does the surgery take?
We reserve approximately three hours for surgery and recovery time. Some of this time is taken by the operating room staff to prepare for the surgery. Individual recovery times may vary.
Do I need to be asleep for this surgery?
You may have a general anesthetic, which will put you to sleep. Some patients prefer to have a spinal or epidural anesthetic, which numbs your legs only and does not require you to be asleep. The choice is between you, your surgeon and the anesthesiologist.
Who will be performing the surgery?
Your orthopedic surgeon will do the surgery. An assistant often helps during the surgery.
Should I exercise before the surgery?
Yes. You should follow the exercises listed in your NoteBook as instructed during your preoperative total knee class. Exercises should begin as soon as possible.
Will I need blood?
Every effort is made to control blood loss during surgery. However, you may need blood replacement and there are many choices to consider. If you have concerns, speak with your surgeon.
How long will I be in the hospital?
Most knee patients will be hospitalized for one to two days after their surgery. There are several goals that you must achieve before you can be discharged.
How often will I need to be seen by my doctor following the surgery?
The frequency of follow-up visits will depend on your surgeon and your progress. Many patients are seen at six weeks, twelve weeks, and then yearly.
Will I need a walker, crutches or any other equipment?
Yes. You will be using a walker or crutches. A therapist will discuss your needs and help you decide what equipment you may need. The care team is available to assist you in getting your equipment arrangements made.
Where will I go after discharge from the hospital?
Most patients are able to go home directly after discharge. Some may transfer to another facility. The care team will help you with this decision and make the necessary arrangements. You should check with your insurance company to see if you have benefits.
Will I need help, or therapy at home?
The first several days or weeks, depending on your progress, you may need someone to assist you with meal preparation, etc. If you need home services or outpatient therapy after discharge, the care team will arrange for services to meet your needs. Family members or friends may need to be available to help you initially.
Preparing ahead of time, before your surgery, can make your discharge to home easier. Having the laundry done, house cleaned, yard work completed, clean linens put on the bed, and frozen meals available may reduce the need for extra help.
Your surgeon will discuss these needs with you before you leave the Bone & Joint Center.
What if I live alone?
Several options are usually available to you. Initially, you may arrange to have someone stay with you, with visits from home health services if ordered by your surgeon. Or you may consider a short stay at another facility following your hospital stay. The social worker is available to assist you if you have concerns.
Will I be able to get back to my normal life?
Getting “back to normal” will depend somewhat on your progress, but consult your surgeon for advice on your activity. The ability to drive, for instance, depends on whether surgery was on your right leg or your left leg, and the type of car you have. The time it takes, and whether you my return to work, and other activities, will be a decision between you and your surgeon. Much depends on your job, the activities you wish to resume, and your progress after surgery.
You will likely be encouraged to participate in low impact activities such as walking, dancing, golf, hiking, swimming, bowling and gardening.
High-impact activities, such as running, singles tennis and basketball are not recommended. Injury-prone sports such as downhill skiing are also dangerous for the new joint. Be sure to discuss any specific activities with your surgeon.
Will I notice anything different about my knee?
Yes. You may have a small area of numbness to the outside of the scar which may last a year or more and is not serious. Kneeling may be uncomfortable for a year or more. Some patients notice some clicking when they move their knee. This is the result of the artificial surfaces coming together and is not serious.