Orthopedics

OSPI offers the top orthopedic surgeons in Gilbert AZ and the East Valley. Drs. Mahoney, Macqueen, Stewart and Clouse offer minimally invasive General, Sports and Joint Replacement expertise.

Physical Therapy

Whether you are pre or post-operative, OSPI’s East Valley physical therapy team works with you on both active and passive treatments. Your will be in the best hands with our licensed physical therapists!

Chiropractic

The Gilbert chiropractors at OSPI offer a plethora of nonoperative pain relief options such as manipulations, laser therapy, physiotherapy and electrical stimulation.

Family Practice

OSPI offers comprehensive family practice services including allergy testing, BHRT, medical weight loss, aesthetics and full check ups.

Medical Weight Loss

Patients routinely experience dramatic, healthy weight loss with the customized programs at OSPI. The programs combine nutrition, exercise and prescription weight loss options.

Performance Training

OSPI’s integrated team of healthcare providers work with both amateur and professional athletes to maximize one’s performance with sport specific programs.

Pain Management

OSPI’s Board Certified, Fellowship Trained pain doctor offers both medication management and interventional procedures with exceptional outcomes!

Total knee replacement

FAQs on Total Knee Replacement in Gilbert, Chandler and Mesa AZ

 

About 600,000 total knee replacement surgeries are performed in the United States every year. Ever since its introduction in 1968, the procedure has been counted one among the safest and most successful medical techniques. Latest advancements have added to its effectiveness to relieve pain, instability, and disability associated with arthritis and severe traumatic injury.

What is total knee replacement?

Total knee replacement refers to surgical removal and replacement of the articular cartilage between the knee bones with artificial implants. Unlike its name, the knee joint is not completely replaced. Only the weight-bearing surfaces are substituted. The end of the femur is removed and a metal implant is fixed to it. The end of the tibia is also replaced with a plastic spacer on a metal stem. A plastic button is attached to the kneecap undersurface depending on the need.

Total knee replacement helps create a new cushion to ensure smooth functioning of the joint. The success of the procedure depends on age, health, weight, and activity of the patient.

What are medical conditions requiring total knee replacement?

Total knee replacement is a treatment option for those suffering from chronic knee pain and disability due to

  • osteoarthritis or degeneration of the knee cartilage
  • rheumatoid arthritis or chronic inflammation in the knee joint
  • post-traumatic arthritis or knee cartilage damage following serious injury or fracture
  • chronic knee stiffness and impairment due to excessive gout or lupus

When should one consider total knee replacement?

A patient is considered for total knee replacement only when

  • there is no significant relief despite using all types of nonsurgical treatments
  • severe pain and stiffness in the knee causing disability
  • patient is diagnosed with irreversible and advance arthritis in the knee
  • the knee is bowed because of severe arthritis.
  • moderate to severe knee pain and inflammation that don’t improve with medication or rest

How is total knee replacement performed?

The surgery is performed under general anesthesia. An open incision is made on the front knee and surgeons disengage the quadriceps muscle from the patella, which is placed aside. This allows them to see the ends of both femur and tibia forming the knee joint.

The damaged cartilage between the tibia and femur is removed. This also involves removal of small amount of bone adjoin the cartilage at both ends. The distal end of the femur is fixed with a round-ended metal implant akin to the joint shape. A flat plastic-on-metal implant is attached to the proximal end of the tibia. Often a stem is inserted into the tibia and the plastic implant is fixed to it. Any deformity, if found, is corrected. Implants on both femur and tibia surfaces are fixed using “press-fit” or bone cementing technique. A plastic spacer is placed between the implants and this becomes a cartilage to ensure smooth gliding surface for the femur and the tibia.

Surgeon may resurface the patella underside according to the need. A plastic button is attached to it depending upon the case.

How long does total knee replacement surgery take?

The surgery takes about two hours. You may be kept away from your family for three to four hours taking into account the anesthesia administration, preparation for surgery, and post-operative observation.

Do I need to stay at the hospital after total knee replacement?

Patients are required to stay in the hospital for 2 to 4 days depending on their condition. The main aim of the hospital stay is to allow the condition to stabilize, the wound to heal, and prevent any complications.

What are the restrictions following total knee replacement?

  • Keep the incision bandage clean and dry
  • No showering for 3 days
  • Rest for a 2 weeks
  • No driving for six weeks
  • RICE therapy (rest, ice, compression, and elevation) for a week
  • Use crutches for 4 to 6 weeks and a brace thereafter for 8 to 10 weeks
  • Avoid weight bearing for 12 weeks
  • Ensure you knee is position comfortable while doing daily activities
  • Avoid twisting your knee or jumping or sudden stress
  • No heavy work before 6 months
  • No heavy-impact activities for life.

What kind of rehabilitation is needed following total knee replacement?

Proper rehabilitation and physical therapy are vital for recovery following total knee replacement. The rehab starts within 4-5 days of the surgery and physical therapy begins after a week. The goal of the rehab is to help regain motion, build strength, and return to normal functions while protecting the knee implant against excessive stress and failure.

The usual rehab protocol includes

  • Week 1 to 4: Passive and active ROM, gait training, gentle mobilization, straight leg raise workouts, avoid flexion or patella contracture, posterior musculature, , etc.
  • Week 4 to 8: Balance/proprioception exercises, stationary bike, straight leg raises, hamstring curls, progress flexion range of motion, heel raises, standing hip flexion and abduction, pool therapy, start functional exercises, etc.
  • Week 8 to 10: Progressive functional and strengthening exercises, full motion, moderate, weight-bearing, aerobic exercise, etc.
  • Week 10 to 20: Squats, step ups, leg press, strengthening exercises, etc.

How long is the recovery period following total knee replacement?

The recovery is subject to age and medical condition. It normally takes a week to return to sedentary work. For heavy labor, patients need at least 6 months rest. It takes about 6 to 8 months to fully recover. But to prolong the life of implants, patients must avoid high-impact activities, such as regular running.

How long the implants last?

Knee implants typically last for 15 to 20 years. However, early implant failure cannot be ruled out depending on your health and activity level.

What are the potential complications of total knee replacement?

The surgery may lead to bleeding, temporary pain, and stiffness. Infection is another complication that requires adequate attention. Follow the medication and guidance of your doctor to avoid blood clotting and pulmonary embolism.

References

Kerkhoffs, GM, Servien, E, et al (Oct 17, 2012). “The influence of obesity on the complication rate and outcome of total knee arthroplasty: a meta-analysis and systematic literature review.” The Journal of bone and joint surgery. American volume 94 (20): 1839–44.

Diduch, DR, Insall, JN, et al. Total knee replacement in young, active patients: long-term follow-up and functional outcome. J Bone Joint Surg Am. 1997; 79: 575–582

Mockford BJ, Thompson NW, Humphreys P, Beverland DE. Does a standard outpatient physiotherapy regime improve the range of knee motion after primary total knee arthroplasty?. J Arthroplasty. 2008 Dec. 23(8):1110-4.

Deirmengian CA, Lonner JH. What’s new in adult reconstructive knee surgery. J Bone Joint Surg Am. 2008 Nov. 90(11):2556-65.

Meneghini RM, Hanssen AD. Cementless fixation in total knee arthroplasty: past, present, and future. J Knee Surg. 2008 Oct. 21(4):307-14.

Della Valle, C and Rosenberg, A. Indications for total knee replacement. in: J Callaghan, A Rosenberg, H Rubash, P Simonian, T Wickiewicz (Eds.) The adult knee. 1st edn. Lippincott Williams & Wilkins, Philadelphia, PA; 2003: 1047–1057

March LM, Cross M, Tribe KL, Lapsley HM, Courtenay BG, Cross MJ, et al. Two knees or not two knees? Patient costs and outcomes following bilateral and unilateral total knee joint replacement surgery for OA. Osteoarthritis Cartilage. 2004 May. 12(5):400-8.

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