Knee Replacement

Knee replacement, also known as knee arthroplasty, is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability. It is most commonly performed for osteoarthritis, and also for other knee diseases such as rheumatoid arthritis and psoriatic arthritis.

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Dr. Bassam Masri, MD, FRCSC, Orthopedic Surgeon, discusses What to Expect From Knee Replacement Surgery Outcomes.

Quiz: Do You Understand Knee Replacement Surgery?

Test your knowledge by answering the following questions:

Questions
True
False
1

If you find everyday tasks such as climbing stairs difficult, you may be a candidate for knee replacement surgery.

Explanation:
If you have chronic knee pain, find everyday tasks such as climbing stairs are difficult or aren’t getting relief from non-surgical knee treatments, it might be time to consult with your primary healthcare provider about knee replacement surgery.
2

Sports injuries are the most common reason that people need knee replacement surgery.

Explanation:
Arthritis is the most common reason that people need knee replacement surgery, including osteoarthritis and rheumatoid arthritis.
3

If the arthritis is localized to one of the two compartments of the knee joint, partial knee replacement surgery is an option.

Explanation:
If the arthritis is localized to one of the three compartments of the knee joint, partial knee replacement surgery is an option. Otherwise, a patient will need a total knee replacement.
4

The surgeon may resurface your kneecap during knee replacement surgery.

Explanation:
During knee replacement surgery, the orthopedic surgeon will remove damaged cartilage and bone; position metal implants; potentially resurface the kneecap (patella) and replace with a plastic prosthesis; and insert a spacer.
5

Knee replacement surgery is generally the first treatment healthcare providers recommend.

Explanation:
Many physicians and orthopedic surgeons advise patients to wait to have knee replacement surgery as long as possible, as the implant begins to wear in the plastic spacer over time.
(Answer all questions to activate)

Dr. Bassam Masri, MD, FRCSC, Orthopedic Surgeon, discusses Knee Replacement Surgical Options.

Dr. Bassam Masri, MD, FRCSC, Orthopedic Surgeon, discusses alternative treatements to consisder before having knee replacement surgery.

What to Expect From Knee Replacement Surgery Outcomes

A knee replacement for arthritis of the knee is a highly beneficial operation. The good or excellent results are 80 to 90 percent after surgery.

Patients are told that 80 percent are extremely happy or ecstatic with the outcome, 10 percent are happy, but not ecstatic, and 10 percent are not happy at all. So right off the bat, one has to accept that there is at least a 10 percent risk of lack of satisfaction, and a 10 to 20 percent risk of ongoing pain after a knee replacement.

One should not expect to have immediate pain relief after a knee replacement. A knee replacement tends to be a fairly painful operation. The pain is fairly intense for the first little while, however it is treated effectively in the hospital with local anesthetic infiltrations, sometimes with blocks, with medications, so that the patient is reasonably comfortable.

However, after surgery the pain tends to continue for a relatively prolonged period of time. When I say pain I mean relatively minor pain. For example, pain at the end of the day, or pain in the evening just before one goes to bed, and that is easily controlled with a painkiller. Just a Tylenol or Advil before one goes to bed, and that gives reasonable comfort.

And that tends to continue for anywhere from six to nine months. And the maximal benefit from a knee replacement isn’t really achieved until anywhere from nine to eighteen months after surgery. So one should not expect to be extremely happy at two weeks or four weeks.

Having said that, most patients tend to use a walker or crutches for a short period of time, basically until they get home from the hospital, which is approximately two to three days. Then they switch over to a cane.

By anywhere from three to six weeks they can get rid of the cane. A lot of patients can start golfing at six weeks. They can resume driving – as long as they’re not taking narcotic analgesics or painkillers – at three weeks. They can return to swimming at six weeks. They can return to fairly vigorous walking at anywhere from four to six weeks.

While they may have a little bit of pain this will get better. The knee will be swollen and warm to the touch for up to a year or two after surgery, and that is not a concern. The knee will be bruised, as will the leg, from the hip potentially all the way down to the ankle for the first few days to a couple of weeks after surgery, and that is also completely normal and not a cause for concern.

There is significant swelling, particularly after a patient goes home, because now they’re walking more, the leg is more dependent, and that is also not a huge cause for concern, because it is a normal feature after a knee replacement.

The final thing that one needs to know about a knee replacement is that the outside of the knee will be numb after surgery. This is not a complication, this is a normal feature of a knee replacement. It is not painful, it is not bothersome, it is simply numb, and patients always ask about this and it is a normal feature.

If you think you have any more questions, or if you’d like to know more about a knee replacement, consult with your physician. Local Physiotherapist

Presenter: Dr. Bassam Masri, Orthopaedic Surgeon, Vancouver, BC

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