Senior living: What to know about knee replacements

By Dr. Andrew Wassef, Guest columnist

Total knee replacements and partial knee replacements are commonly performed surgeries for seniors to address pain associated with arthritis.

Osteoarthritis is the most common type, which often causes debilitating pain, limited range of motion and instability of the knee joint. Persistent knee pain, despite conservative measures, such as medication and weight management, along with factors like knee deformity or limited functionality, may make seniors eligible for knee replacement.

If any of this applies to you, we’ll help you determine which knee replacement surgery is right for you by explaining the difference between the two below.

What is a total knee replacement?

Total knee replacement involves replacing the knee joint with artificial parts made of metal and high-grade polyethylene plastic.

This procedure is performed to alleviate severe pain caused by arthritis. Most patients are able to go home within one day of surgery. Recovery time varies, but most people can resume normal activities within four to six weeks.

Total knee replacement is an option when arthritis has progressed to all three compartments of the knee or when patients are ineligible for partial knee replacement. Total knee replacement is an option for seniors experiencing severe knee pain or stiffness resulting from degenerative joint disease (including osteoarthritis, traumatic arthritis or avascular necrosis), rheumatoid arthritis or post-traumatic arthritis of the entire knee.

Total knee replacement surgery offers several benefits for seniors with severe knee damage:

• Pain relief: Total knee replacement surgery replaces damaged bone and cartilage with artificial components, providing significant relief from chronic knee pain both during movement and at rest.
• Improved mobility and function: This surgery corrects leg deformities and restores normal joint function, allowing individuals to resume daily activities with improved mobility and range of motion.
• Enhanced quality of life: By reducing pain and improving mobility, total knee replacement significantly enhances the overall quality of life, enabling individuals to engage in activities previously limited by knee pain.
• Long-term durability: Advances in surgical materials and techniques have improved the durability of total knee replacements, providing long-lasting relief and improved joint function.

What is a partial nnee replacement?

Partial knee replacement is a surgical procedure focused on replacing only one or two affected areas of the knee joint.

During the surgery, the damaged parts of the knee joint are removed and replaced with a prosthetic joint made of metal and plastic.

When arthritis is confined to a single compartment of the knee and there is no significant stiffness or angular deformity, partial knee replacement may be suitable for seniors. Patients older than 80 years of age who don’t have as much damage may prefer this procedure.

Partial knee replacement is a good option for patients experiencing severe knee pain or stiffness resulting from degenerative joint disease (including osteoarthritis, traumatic arthritis, or avascular necrosis), rheumatoid arthritis or post-traumatic arthritis in only part of the knee joint. Partial knee replacement offers several benefits compared to total knee replacement, including:

• Preservation of range of motion and knee function: By retaining healthy tissue and bone in the knee, partial knee replacement better preserves the range of motion and knee function, leading to improved mobility and functionality post-surgery.
• Reduced blood loss: Partial knee replacement generally involves less blood loss during surgery compared to total knee replacement.
• Faster recovery: Partial knee replacement allows for a faster recovery period compared to total knee replacement. Patients often are able to walk without any assistive devices within two weeks of surgery and return to normal function more rapidly.

Factors to consider

To determine if a senior is eligible for knee replacement surgery, several criteria are considered:

• Arthritis confined to a single compartment: Partial knee replacement may be an option for seniors with arthritis limited to a specific area of the knee.
• Being severely overweight: Seniors with a BMI over 40 may not be considered eligible for partial knee replacement.
• No marked stiffness or significant angular deformity: Severe stiffness or significant angular deformities in the knee may disqualify seniors from partial knee replacement.

What is the expected recovery time?

The expected recovery time for a total knee replacement for seniors can vary based on several factors.

Seniors can anticipate a recovery period of approximately one year to fully recover from a total knee replacement, but most activities can be resumed within six weeks after surgery. Factors such as pre-surgery activity level, age and overall health condition can influence the recovery time.

The life span of a knee replacement varies by each person. Please always consult with your physician first to talk through what is best for you.

Dr. Andrew Wassef is a fellowship-trained, board-certified orthopedic surgeon and medical director of MemorialCare Joint Replacement Center at MemorialCare Long Beach Medical Center. Wassef received his medical degree from Howard University College of Medicine in Washington D.C. and a residency in orthopedic surgery at the University of Toledo Medical Center in Toledo, Ohio. He then completed his fellowship in total joint replacements at the Joint Replacement Institute at St. Vincent Medical Center in Los Angeles.