The largest joint in the body, the knee is one of the most crucial joints involved in movement. The femur, tibia, kneecap (patella), cartilage, muscles, ligaments, membrane and fluid all work together to ensure mobility in a healthy knee. Osteoarthritis, injury or disease can interrupt the normal functioning of the joint and cause pain and problems moving. Often, a knee replacement is the best option for relief. This can be done in patients of all ages, including the elderly.
Preparing for Knee Replacement Surgery
The first step in determining if knee replacement surgery is right for you is to have a medical evaluation. The practitioner will assess any other health problems you have that might cause problems during surgery, such as problems with anesthesia, heart problems, or breathing difficulties. Lab tests and x-rays may also be performed. Your surgeon may require a clearance signed by your primary care provider releasing you for surgery. You will also be told to guard against any breaks in the skin, infections, or bites on the affected leg prior to surgery. A physical therapy evaluation will also be performed, at which time you will be counseled on home care after surgery and any adaptations that may need to be made to your home to ensure your mobility and safety. This may include raised toilet seats, handrails, having a walker or cane, having someone stay with you if you live alone, or even going to a rehabilitation center post-surgery, which is often recommended for elderly patients so constant monitoring of their condition can be performed.
The Surgery
Knee replacement surgery takes about two hours, in which the surgeon removes damaged cartilage and bone, then places the new metal or plastic knee joint. Total or partial knee replacement may be performed depending upon your situation. Following either surgery, you will stay in the recovery room for an hour or two, then be moved to a regular hospital room, where you will stay for three to four days. Your physical therapy will begin soon after surgery, as restoring movement to the joint is of the utmost importance. You may be prescribed blood thinners, special compression socks or other measures to prevent blood clots after surgery. After your hospital stay is over, you will either move to a rehabilitation center for 20 to 30 days, or be sent home if that is an option and go to physical therapy a few times a week for at least a month.
Prognosis of Knee Replacement in the Elderly
Following knee replacement surgery, approximately 17 percent of elderly patients experience complications like clots or infection. Thirty-eight percent experience pain lasting more than four weeks post-surgery. Recovery takes approximately a month in elderly patients, with most needing help with activities of daily living for a month or more. One year following surgery, elderly patients experience more relief from osetoarthritis pain. A knee joint that is replaced is expected to last 10 to 15 years, which usually correlates to the remainder of the life span of an elderly patient.
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