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Total Knee Replacement Surgery: Being Realistic About Results


By Becky Wiese

If you’re of a certain age (and if you have been experiencing knee pain due to osteoarthritis for a while, you are probably the right age), you might remember a television show about a man who experienced a terrible crash and was fitted with artificial body parts that made him “better, stronger, faster.”

Not only were several parts replaced, they were enhanced—he could do amazing things using these “bionics” (which, according to Webster, means having normal biological capability or performance enhanced by or as if by electronic or electromechanical devices)—some of which he could do before, now just better, and other things he had never been able to do before.

Sounds great, doesn’t it?

Of course, it was fiction. And although medical science has made huge strides in creating replacement body parts, we aren’t quite to the “bionic” level yet.

Take a total knee replacement (TKR), for example. Patients who have suffered through years of pain due to osteoarthritis with their knee and have tried everything from over-the-counter meds to injections to exercises may finally get to the point that total knee replacement surgery provides the best hope for dealing with the pain and the lifestyle changes it’s caused over the years.

When a patient says Enough! with the pain and talks with an orthopedic surgeon about what it will take to get their life back, they want significant relief. And the surgery can give it to them, but it’s important to know all the facts ahead of time. The most important fact? Your knee won’t be bionic post-surgery.

That’s not to say there isn’t a great deal of benefit.

On the contrary, according to Dr. Luke Armstrong of McLean County Orthopedics, “total knee replacements are the third most satisfying surgeries in the world in terms of people getting their life back and being able to function and contribute back to society. Only cataract and hip replacement surgeries have higher satisfaction rates.”

“A total knee replacement offers a patient a well-functioning, less painful, more stable knee,” he says. “By and large, most people are glad they did it. Very often patients tell me it gave them their life back.”

Dr. Armstrong is very clear about expectations, as he feels it is imperative that a patient know what is realistic and normal for a post-operative TKR to feel like. “The biggest thing people need to know is that, with a knee, you’re always going to know it’s fake. It’s not going to feel like the knee you were born with—not even the knee you had at twenty years old.”

One reason for this is that it’s anatomically impossible for a knee replacement to be a perfect substitute for a person’s natural knee. It may never be the same size and may swell more easily. It may make a clicking sound or feeling because the implant is made up of metal and plastic and they contact each other in the natural motion of walking or bending the knee. There may be some numbness on the side of the knee where the incision was made.

While the goal of a total knee replacement is to decrease pain, increase range of motion, and allow for more activity, the restoration of full motion is uncommon. Additionally, some activities should be on the “do not do” list.

“Running and jumping are probably out,” says Dr. Armstrong, “and kneeling might be painful unless you use a knee pad or cushion of some kind, but walking, using an elliptical, playing doubles tennis, swimming, golf—are all feasible, based on each individual’s pain level.” Think low impact rather than high impact, because having a metal and plastic implant surrounded by your natural tissue and nerves would likely be a painful experience when they come together under force.

Another realistic expectation Dr. Armstrong wants to emphasize is the total recovery time. Yes, you will likely be up and moving within 24 hours of surgery, but total recovery time may take longer than you thought. The first four to six weeks include pain management strategies and goals for regaining function for activities of daily living. Endurance starts to come back and life seems like it’s getting back to normal.

During weeks 8 to 11, maintaining the prescribed exercise regimen is crucial to gaining strength, balance, and mobility. And even though you’re probably feeling pretty good by this point, going back to high-impact activities is a no-no, as they might damage the implant or the surrounding tissue that is still healing.

Continuing to follow the surgeon’s and physical therapist’s instructions for an entire year is the most beneficial strategy to getting the fullest range of motion. Typically, according to Dr. Armstrong, the function your knee has at the one-year point is what you can expect for the life of the joint, although, he explains, “feeling fully recovered as far as stairs go may take up to two years.”

Most patients are highly satisfied with their total knee replacement, especially those who know what to expect, and what not to expect, over the long term. Less pain, better stability, better function? Absolutely. It might feel a little fake, but it allows them to participate in life again. If it’s been a busy day, it might be sore at night, but it’s nothing that some over-the-counter meds can’t take care of, and it feels fine by the morning.

In the end, you may not be bionic, but keeping your expectations realistic and following the instructions that your surgeon and physical therapist provide will give you the best results possible.

For more information, you may contact McLean County Orthopedics at 309-663-6461 or Their office is located at 1111 Trinity Lane in Bloomington. McLean County Orthopedics is the area’s one-stop-shop for comprehensive orthopedic care, pain management, and rehabilitative services. Schedule an appointment today if you have chronic pain or for sudden injuries, visit their Walk-In Ortho Care Clinic where no appointment is needed. McLean County Orthopedics – Improving Your Health, Improving Your Life.