Knee Replacement: Cost, Procedure, and Recovery

In a world where mobility is key to leading a fulfilling life, knee pain can be an immobilizing hindrance. Knee replacement surgery, also known as total knee replacement (TKR) or partial knee replacement (PKR), is a medical procedure aimed at restoring mobility, reducing pain, and improving the overall quality of life for individuals suffering from severe knee joint issues.

Why people opt for knee replacement

Knee replacement is chosen when alternative treatments, such as physical therapy or medication, prove ineffective in alleviating pain and improving mobility. Common conditions that may lead to knee replacement include osteoarthritis, rheumatoid arthritis, and injury-related joint damage.

Types of knee replacement

Total knee replacement (TKR)

In a TKR, the entire knee joint is replaced with a prosthetic implant, typically made of metal and plastic components. This procedure is performed when both the medial and lateral compartments of the knee are damaged.

Partial knee replacement (PKR) 

In a PKR, only a portion of the knee joint is replaced. This is a viable option when the damage is confined to a specific compartment, preserving healthy bone and tissue.

Alternatives to knee replacement

Before opting for knee replacement, it's worth exploring less invasive alternatives. These may include medication, physical therapy, lifestyle modifications, or injectable treatments. Consult with your orthopedic specialist to determine the most suitable option based on your unique situation.

Knee replacement surgery cost

The cost of knee replacement surgery can range from $20,000 to $60,000, depending on the hospital, surgeon's fees, and the type of implant used. It's essential to discuss the expected expenses with your healthcare provider and insurance to plan accordingly.

Knee replacement: How to prepare

The journey begins with a thorough consultation with an orthopedic surgeon. During this meeting, your surgeon will:

• Review your medical history to ensure you are a suitable candidate for knee replacement.
• Discuss your current symptoms, pain level, and how they impact your daily life.
• Conduct a physical examination of your knee joint to assess its condition.
• Answer any questions or concerns you may have about the procedure.

It's essential to be open and honest with your surgeon during this consultation, as this will help them tailor the surgery to your specific needs.

Medical evaluation and medication review

In the lead-up to your knee replacement, your surgeon may recommend various medical evaluations, like blood tests (to check for any underlying health conditions that might affect the surgery), imaging (X-rays and, in some cases, MRI scans to assess the extent of the damage to your knee joint), and cardiovascular evaluation (to ensure your safety during surgery).

Completing these evaluations helps your surgical team understand your overall health and tailor the procedure accordingly.

In the weeks leading up to your surgery, your surgeon will also review your current medications. Some medications, such as blood thinners, may need to be adjusted or temporarily discontinued to reduce the risk of bleeding during surgery. 

Preoperative optimization

To enhance your overall health and prepare your body for surgery, your surgeon may recommend lifestyle adjustments, like engaging in low-impact exercises to improve strength and flexibility, maintaining a balanced diet rich in nutrients, and if needed, losing excess weight. 

Your surgical team will provide you with comprehensive information about the procedure, what to expect during your hospital stay, and the recovery process. This education empowers you with knowledge about what's to come, reducing anxiety and ensuring a smoother experience.

Home preparation

Preparing your home for your return from the hospital is vital. Consider these home adjustments:

• Accessibility: Make sure your home is easily navigable with minimal obstacles and hazards.
• Assistive devices: Acquire any necessary assistive devices, such as crutches, a walker, or a raised toilet seat.
• Support system: Arrange for a friend or family member to assist you during the initial days following surgery.

What is the best age to have a knee replacement? 

There is no one-size-fits-all answer, but knee replacement is often considered when conservative treatments are no longer effective, typically in the 50s, 60s, or older.

Knee replacement surgery

The surgical procedure itself typically takes around 1-2 hours, depending on the complexity and type of knee replacement. During surgery, damaged cartilage and bone are removed, and the prosthetic components are securely implanted, restoring the knee's function. 

In cases of total knee replacement, the entire knee joint is replaced. Partial knee replacement, on the other hand, involves the replacement of only the damaged portion of the knee, preserving healthy bone and tissue. The choice between these two options depends on the extent of knee joint damage and is determined during the surgical evaluation.

Here’s a more detailed breakdown.

Anesthesia

The surgery begins in the operating room with the administration of anesthesia. Most patients undergo either general anesthesia, where you are completely unconscious, or regional anesthesia, like a spinal or epidural block, which numbs the lower half of your body while you remain awake. The choice of anesthesia depends on your medical condition, preferences, and the surgeon's recommendations.

Incision

The surgeon starts by making an incision, typically around 8-12 inches long, on the front of your knee. This incision allows them access to the knee joint.

Reshaping the bone

The next step involves reshaping the ends of the thigh bone (femur) and shin bone (tibia) to accommodate the prosthetic components. This ensures a snug fit for the artificial joint.

Implant placement

The prosthetic components consist of metal and plastic parts. The metal components are typically made of titanium or a cobalt-chromium alloy and mimic the surface of the bone, providing a stable foundation. The plastic spacer is placed between these metal components, serving as a cushion that allows for smooth movement.

Patella resurfacing 

In some cases, the back of the kneecap (patella) may also be resurfaced with a plastic component to enhance joint function.

Final assessment

Before closing the incision, the surgeon meticulously assesses the artificial joint's stability, mobility, and alignment to ensure it functions correctly.

Closing the incision

After a thorough examination, the surgeon closes the incision with sutures or staples, and a sterile bandage is applied to protect the wound.

Knee replacement recovery time and post-operative care

Recovery following knee replacement surgery is a multi-faceted journey, with a range of factors influencing the duration and success of the process. 

Initial days

In the hours and days immediately following knee replacement, the focus is on managing pain, monitoring vital signs, and initiating early mobility.

Pain management is a top priority. Medications, often administered intravenously initially, are adjusted as necessary to keep pain at a manageable level.

Early movement is crucial to prevent complications such as blood clots and to initiate the recovery process. Physical therapy begins as soon as the patient is stable, often on the same day as the surgery. Patients are encouraged to stand, walk with assistance, and perform gentle exercises to improve strength and mobility.

Weeks 2-6

The second phase of recovery focuses on regaining strength and mobility. Physical therapy continues with the goal of improving range of motion, strength, and flexibility in the knee joint. Patients may also learn exercises they can perform independently at home.

Most patients can resume light activities like walking and climbing stairs within a few weeks. More strenuous activities are gradually reintroduced over the next several weeks. The timeline for this transition varies depending on individual progress.

Surgeons typically schedule follow-up appointments to monitor the healing process. X-rays may be taken to ensure the implant is in the correct position.

Months 3-6

This phase is focused on long-term recovery and regaining full function of the knee. Physical therapy may continue for several months, focusing on strength training and flexibility exercises. These sessions help patients regain a higher level of function and independence.

Many patients can return to most of their regular activities within this timeframe. However, it's essential to consult with the surgeon and physical therapist to ensure that high-impact or strenuous activities are reintroduced safely.

The knee joint continues to heal during this phase, and it may take several months to achieve maximum improvement in strength and range of motion.

Knee replacement recovery timeline

The usual recovery process following knee replacement is as follows:

Short-term recovery: Most patients experience reduced pain and improved mobility within the first 6-8 weeks.

Medium-term recovery: By the 3-6 month mark, patients often return to most of their regular activities and see substantial improvements in strength and mobility.

Long-term recovery: Full recovery can take up to a year. While patients may have a high level of function earlier, it can take this long for the knee to fully heal and reach its optimal strength and mobility.

Discuss knee replacement with the best orthopedic surgeons on PreferredMD

Delaying knee replacement surgery can lead to worsening pain, reduced mobility, and a decreased quality of life. So it's crucial to discuss the timing with your orthopedic surgeon to make an informed decision.

Knee replacement is a transformative procedure that can offer newfound freedom and comfort to individuals suffering from debilitating knee pain. When performed by a skilled orthopedic surgeon, it can be life-changing, allowing patients to regain an active and fulfilling life. Remember, the key to success lies in proper preparation, understanding the procedure, diligent post-operative care, and timely decision-making.