Are you a good candidate for a Total Knee Replacement?

When a someone is considering having a total knee replacement, there are a couple factors that will be taken into consideration on whether that individual would be a good candidate and would have positive outcomes after the surgery.

Factor 1: Age

Surgeons generally do not like to perform knee replacements for patients who are younger than 60 years old. The reason why age must be taken into consideration is due to the components of the joint replacement breaking down. Just as the natural joints within our bodies break down, so do the components of joint replacements. If a patient has a joint replacement too early, there is a strong likelihood the joint replacement would need to be revised requiring an additional surgery. However, this doesn’t mean a surgeon will not perform a knee replacement on a surgeon younger than 60, it is just one factor to consider.

Factor 2: Evidence of Knee Osteoarthritis

By confirming whether a patient truly has severe knee osteoarthritis through x-ray imaging will help a surgeon determine if a patient will be a good candidate. The surgeon will make sure the symptoms the patient is experiencing is due to osteoarthritis and not due to another medical condition or pathology. If the patient experiencing their symptoms due to another medical condition, a total knee replacement may not be the best option to treat their symptoms and may have poor postoperative outcomes.

Factor 3: Pain from Osteoarthritis

The last factor to consider is the severity of the knee osteoarthritis the patient is experiencing. Generally, surgeons need to take in consideration how a patient’s symptoms are impacting their everyday life. If a patient is experiencing pain that limits their ability to perform everyday tasks such as performing stairs or walking within their home or community safely then the patient would most likely be a good candidate for a knee replacement. However, if a patient is not experiencing severely limiting pain which would impact their ability to live their everyday life then they may not be a good candidate for a total knee replacement. There are more factors to consider if a patient would be a good candidate for a joint replacement but these are good factors to consider at the beginning of the decision process. Also, if a patient doesn’t meet one of these factors it doesn’t mean they would not be a good candidate. They are simply factors in the equation to consider.

What to Expect for the Day of Surgery and Recovery Time

If you’re considering having a total knee replacement you might be curious what the entire process entails and how long the recovery time is.

Anesthesia

The surgeon will either use general anesthesia or spinal anesthesia for the surgery. General anesthesia will make you unconscious for the procedure whereas spinal anesthesia will leave you awake but you will not feel any pain from the waist down. Some surgeons also use a technique called nerve block to help with pain control after the procedure. The surgery generally lasts for about 2 hours and afterward, you will stay in the recovery room for 1-2 hours.

Hospital or Skilled Nursing Stay

Patients will generally stay in the hospital for a couple days and will receive physical therapy during their stay to begin their rehabilitation process. Physical therapy in the hospital generally entails exercises to improve your muscles contracting, improving your ability to bend your knee, and getting you walking again. Once a patient is ready, he/she will either go back to their home or possibly a skilled nursing facility. Generally, patients will go to a skilled nursing facility if they live alone or don’t have a good support system at home that will allow them to function safely. Patient’s should expect an average stay of 1-2 weeks in a skilled nursing facility depending on how quickly they recover.

Return to Home and Outpatient Rehabilitation

If a patient is able to return to their home, they will either receive home physical therapy or go to an outpatient clinic to continue their rehabilitation. Time expected for a patient to go through physical therapy and return to their normal daily activities varies from 4 to 6 weeks. The goals for physical therapy are to improve your range of motion, strength, and balance to allow you to walk around and interact within your home and community as you were prior, if not better than before.

If you are experiencing knee pain, contact a physician or a physical therapist to help manage pain and potentially prevent or delay surgery.

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Eric Whelan graduated from Concordia University (Portland, OR) with a Bachelor of Arts in Exercise Sports Science. He then went on to pursue his Doctor of Physical Therapy from Concordia University (Wisconsin).