What You Need to Know About Knee Replacement: When It’s Needed and Alternative Treatments

A knee that functions well enables a person to run, dance, climb stairs, and enjoy their favorite hobbies. When something's not right, it can limit a person's ability to participate in these activities. Whether it's chronic pain, a sports injury, or arthritis, knee health can be impacted in many ways during a patient's lifetime. Fortunately, several treatments are available to improve joint functionality and quality of life.

At Reflex Knee Specialists, the medical team offers non-surgical services for patients with a variety of knee issues. Here, we discuss knee replacement surgery in detail and provide insights into some of the advanced non-surgical treatments that can boost joint health and delay the need for surgery.

What Does Knee Replacement Surgery Entail?

During knee replacement surgery, or total knee arthroplasty, the surgeon removes diseased or damaged parts of the joint and replaces them with a synthetic implant. Knee joint protheses are typically made from metal or plastic and generally last 15-20 years. If the implant eventually loosens or shows signs of wear, the patient may need a second replacement, which is called a revision surgery. This issue is more common with patients who had a knee replacement performed at a younger age. The complication rate following revision surgery is higher and the outcomes are poor compared to an initial joint replacement.

Knee replacement surgery is usually performed under general anesthesia and can take between one and two hours. During a typical knee replacement procedure, the orthopedic surgeon does the following:

• Makes an incision in the patient's knee
• Removes damaged areas in the knee joint
• Resurfaces damaged areas with a prosthesis that affixes directly to the bone
• Closes the incision using sutures or surgical staples
• If necessary, places a drain at the incision site to remove excess fluid
• Applies a sterile bandage to the surgical site to help protect the wound as it heals

Today, robotic arm-assisted orthopedic surgery is common for knee replacements. Under the guidance of the surgeon, robotic knee replacement technology helps ensure the procedure is completed with a high degree of precision and preserves as much healthy bone and tissue as possible.

Signs You May Need a Knee Replacement

Often a last resort when non-invasive methods have proven insufficient, knee replacement surgery is recommended by providers for several reasons. Patients with the following conditions may undergo surgery at some point in their lifetime:

• Osteoarthritis
• Rheumatoid arthritis
• Traumatic knee injury
• Physical deformity

Patients may be candidates for knee surgery if any of the following apply:

• Chronic knee pain is increasing in intensity and frequency
• Limited mobility in the joint increasingly affects range of motion and stability
• Swelling and inflammation persist through medication and other treatments
• Everyday activities are increasingly challenging without assistance, such as climbing stairs, standing up, or sitting down

In certain cases, surgery can be delayed or even prevented through alternative treatments. Speaking with a knee specialist is the best way to find a treatment plan that works best for your joint health and circumstances.

What to Expect After Knee Replacement Surgery

After a knee replacement, the patient will rest in the recovery room where they'll be observed by the medical team. They'll monitor the surgical site, as well as the patient's vitals. Once the patient is alert and stable, they will be moved to a hospital room to rest. The amount of time a patient spends in the hospital depends on several factors, such as their overall health and whether complications arise during the procedure. The physician will prescribe pain medications to help alleviate the discomfort felt after surgery, as well as blood thinners to help prevent blood clots, if necessary.

Before going home, each patient receives post-surgical recovery instructions, rehabilitation guidance, and other health resources. Generally, the patient can resume everyday activities six weeks after surgery. Common recommendations given include:

• Start moving the joint right away – this may be done with the help of crutches or a walker
• Elevate the knee and apply ice to manage swelling
• Wear compression stockings to help prevent blood clots
• Take pain relievers as prescribed by the physician
• Keep the surgical site clean and dry (sutures/staples will be removed during a follow-up visit)

Patients are also advised to make any necessary modifications at home to help reduce their risk of injury as the knee heals. This may include using the following:

• Safety handrails, a raised toilet seat, and a shower chair in the bathroom
• Dressing aids in the bedroom to help with getting ready for the day
• A reacher device that makes it easy to grab items without straining

Follow-Up Care After Knee Replacement Surgery

Soon after knee arthroplasty, patients go to physical therapy. Licensed physical therapists work with the patient to assist them and ensure a successful recovery. Along with giving daily living instructions for getting out of bed, dressing, and more, a physical therapist sets goals for the patient and provides an exercise program to help them reach those milestones.

While it may seem like less movement may help the knee heal, this is counterproductive. Doctors often recommend regular movement and exercise for several reasons, such as:

• Slowing scar tissue development that can hinder range of motion
• Strengthening the supporting muscles around the joint
• Minimizing swelling and inflammation
• Reducing joint stiffness
• Maintaining balance
• Working toward a normal gait

Types of Knee Replacements

The anatomy of the knee joint includes the tibia (shinbone), femur (thighbone), and patella (kneecap). Cartilage covers the surface of the bones at the joint, cushioning the area and minimizing friction. The synovial membrane lubricates the joint and promotes fluid movement. Ligaments and tendons are the connective tissues that support proper motion and link muscle to bone. When there's an issue within the joint, multiple surgical procedures may be recommended by a physician, such as:

• Total knee replacement surgery: This procedure takes care of the entire knee joint.
• Partial knee replacement surgery: An alternative to total knee replacement, this surgery resurfaces a specific knee compartment.
• Patellofemoral replacement surgery: During this procedure, the surgeon replaces the area under the patella (kneecap).

Knee Replacement Alternatives

Knee replacement surgery is just one approach and should only be considered after conservative measures have failed. There are several non-surgical knee treatments available to patients. At Reflex Knee Specialists, providers can recommend these alternative treatments to help alleviate knee pain, prolong the need for surgery, and support joint health. Treatments include:

Platelet-Rich Plasma (PRP) Therapy

Utilizing the body's natural growth factors, platelet-rich plasma (PRP) therapy is an evidence-based treatment that's highly effective for many patients. This includes athletes with a tendon or ligament injury, those suffering from chronic osteoarthritis pain, and individuals experiencing discomfort that stems from a past knee injury. Benefits of PRP therapy include:

• Decreased inflammation
• Enhanced synovial fluid quality
• Increased joint lubrication, cushioning, and mobility
• Pain reduction

Joint Fluid Therapy

Joint fluid therapy addresses chronic knee pain. Also called viscosupplementation, this treatment adds hyaluronan (hyaluronic acid) into the joint to help bolster the quality of synovial fluid. A natural component of human tissue, hyaluronan helps the joints maintain their mobility. Some of the advantages of this therapy include:

• Reduced chronic knee pain
• Restored elasticity
• Slowed cartilage breakdown
• Long-lasting results (several months to a year)

Additional Joint Treatments

A physician may recommend knee bracing to help stabilize or strengthen the joint which is highly beneficial for many patients. Benefits of a knee brace include the following:

• Alleviates pain, stiffness, and swelling
• Increases the ability to walk and exercise
• Decreases joint stress
• Corrects compensation patterns that can cause other issues
• Promotes proper joint alignment and muscle firing

A knee specialist may also recommend physical therapy. Many people go to physical therapy after an accident, sports injury, surgery, or when experiencing a chronic knee condition. For example, the licensed physical therapists at Reflex Knee Specialists provide a full-body assessment to identify the sources of pain or areas where function or movement is compromised. Through individualized treatment plans with clearly defined goals and strategies, patients can learn how to manage their condition and improve their overall quality of life.

Consult Experienced Non-Surgical Knee Specialists

Those seeking non-surgical treatments for knee pain can find the comprehensive care they need at Reflex Knee Specialists. Our offices are located in Portland, Oregon; Bellevue, Washington; and Tempe, Arizona. Contact us to schedule an appointment today.