Disruptive knee pain may require a knee replacement (as pictured in the left side of the photo here) to improve your quality of life.

© Puwadol Jaturawutthichai | Dreamstime.com

From knee replacement alternatives like arthroscopy to total joint replacement, surgeons can employ a variety of techniques to ease joint pain and improve function. Which procedure is right for you depends on the type and severity of arthritis you have, the joint affected, your age, and overall health.

The primary reason to consider joint replacement (arthroplasty) for arthritis is pain that disrupts your daily life and does not respond to other treatments. Of all the surgical options, only joint replacement is viewed by doctors as a long-term cure.

How Long Do Joint Implants Last?

When first used in the 1970s, joint implants lasted about 10 years. Today, with better surgical techniques, improved prosthetic designs, and stronger materials, most joint implants can be expected to last 20 years or more. And researchers continue to develop better designs that aim to give you near-normal range of motion and function for the rest of your active life.

Knee Replacement Basics

• Unicompartmental or partial knee replacement is similar to total knee replacement in that the worn surfaces within your knee are replaced by metal and plastic parts. However, rather than realign and resurface both the medial (inside) and lateral (outside) compartments of the knee joint as in total knee replacement, the unicompartmental, or partial, knee replacement resurfaces and replaces only the medial or lateral compartment of the knee. In both surgeries, the end of the femur and the top of the tibia are replaced.Compared to those receiving a total knee replacement, partial knee replacement patients may recover faster. For older patients, it helps with knee stability, since you keep all of your ligaments intact. On the downside, it tends to wear out faster than a total knee replacement—in as little as 10 years, compared to 20 with a total knee implant.
• Total knee replacement is the only procedure in which you remove everything that is, or could become, diseased—the cartilage, the linings, and the ends of the bones. Research suggests that total knee replacement can ease pain, and improve physical and social functioning, balance, and vitality in older adults.Some studies have found that replacing a knee or hip may reduce the risk of cardiovascular complications, probably because the surgery improves a person’s capability for physical activity.
• Minimally invasive total knee replacement is an effective operation. Traditional total knee replacement entails cutting through muscles and tendons around the knee, a long and sometimes painful recovery, and a significant scar. In minimally invasive total knee replacement, the surgeon does not cut the quadriceps muscle but instead spreads apart the muscle fibers and uses smaller instruments to make cuts to the bone similar to those in traditional total knee replacement. A smaller incision and less cutting of tendons and muscles allows for faster recovery.
• On the downside, working through a smaller incision is surgically challenging, making it more difficult to achieve precise cutting angles and optimal anatomic alignment between bone and implant. Some studies have shown a higher rate of complications with minimally invasive versus traditional knee replacement.

Knee Replacement Recovery

Evidence in recent years shows that people having minimally invasive surgery can recover in about half the time as those with traditional knee replacement, without any apparent reduced risk of long-term success. This means being able to walk without a cane or get out of bed or a chair unassisted in perhaps three to four weeks, instead of needing six to eight weeks.

Improvements in surgical techniques and recovery protocols have led some experts to recommend shorter hospital stays or even outpatient procedures for joint replacement patients. The theory is that cutting the typical three- to four-day hospital stay down to one or two (or none at all) may reduce the risk of post-operative complications, such as infections. (See our post “What Is Septic Arthritis” or the Medical News Today post “Knee Replacement Infection: What You Need to Know.”)

Medications After Surgery

Medications and physical therapy also may help speed your recovery. One study found that taking celecoxib around the time of the operation led to a more rapid and less painful recovery from total knee replacement, while another found that physical therapy on the day of surgery shortened hospital stays significantly among those undergoing knee or hip replacements.

Conversely, another study found that people taking opioid pain relievers—such as hydrocodone (Vicodin, Lortab) and oxycodone (OxyContin)—before surgery had longer hospital stays, lower function, and less mobility in the replaced knee, and more pain, stiffness and complications two to seven years after surgery.

Fear of pain and re-injury can inhibit recovery after knee surgery, often resulting in avoidance of physical activity and the development of decreased muscle strength, limited range of motion, weakness in the cardiovascular system, and weight gain.

Originally published in 2016, this post is regularly updated.