Q & A: What You Need to Know If You're Considering Total Knee Replacement

The largest joints in the body, our knees, allow us to do countless daily activities, such as walking, bending, turning, and even standing. When one breaks down, doctors can replace it with a knee made from plastic and metal. Jorge Corzo, M.D., physical medicine and rehabilitation specialist and medical director of Riverview Rehabilitation Center, answers questions you may have if you're thinking about having this procedure.

Q: How do I know if surgery is the best option for a knee problem?

A:Total knee replacement offers relief to people whose knees have been damaged by some form of arthritis — most often osteoarthritis — or injury.

"In the past, doctors considered the best candidates to be those between ages 60 and 75," says Dr. Corzo. "But in recent decades, with improvements in materials and technology, more and more people of virtually all ages have had successful knee replacement surgery. In fact, for about 90 percent of those who choose it, this surgery drastically lessens pain, improves daily functioning, and enhances overall quality of life."

Knee replacement might be your best option if physical therapy, medicines, or other procedures aren't enough to control your pain. Your doctor can help you decide if this type of surgery is right for you.

Q: What should I do to prepare for this operation?

A: According to Dr. Corzo, you may need a complete physical. "This helps your doctor determine whether you have health conditions that could interfere with the procedure. A visit to the dentist might be in order, too. While infections after knee replacement are rare, some dental problems could potentially trigger them."

Before your procedure, make your home easier to navigate. For instance, place safety bars or rails in the shower or bath and handrails along stairways. Remove all loose rugs, and tuck electrical cords out of your way. Also helpful are a shower bench or chair and a toilet seat riser with arms. If your bedroom isn't on the first floor, arrange a temporary "bedroom" there. Going up and down stairs likely will pose a challenge during your early recovery.

"It's important to ask your doctor if you should do any exercises before surgery," adds Dr. Corzo. "Arm, chest, and shoulder exercises may enable you to use crutches or a walker more easily. In addition, performing legstrengthening exercises prior to surgery might bolster recovery."

Also, plan to get help with tasks such as cooking, shopping, and bathing for several weeks after surgery.

Q: How long will recovery take?

A: "You'll probably stay in the hospital for several days," states Dr. Corzo. "Once home, you will need to perform special exercises to rebuild muscles. You should be able to resume most normal activities within three to six weeks."

"What's important to remember," Dr. Corzo concludes, "is that knee replacement surgery has come a long way in the past 20 years. One thing that has helped advance joint replacement surgery is the role of the physiatrist. The physiatrist, along with our surgeon, can help create individually tailored therapy programs that make for a faster and more effective recovery."

"In addition, there are procedures, called minimally invasive joint replacement, that involve smaller incisions, minimal discomfort, and a much shorter recovery. Those considering knee replacement should check with their orthopedic surgeon to see what procedure is best for them. For thousands of people each year, knee replacement means a much better quality of life."