Dr. Mark Matthes discusses total knee replacement.

Who is an ideal candidate for total knee replacement?

Total knee replacement is certainly an option for someone who has extensive arthritis in their knee, to the point where we would call it ‘bone-on-bone arthritis,’ where there is no cartilage left in at least one location inside the knee. At that point, it doesn't really mean that that person must have surgery. The reason for doing the surgery is not only based on you being a candidate because you have the bone-on-bone arthritis, but it is also based on if you are you able to do the things that you want to do. And if you can still manage, even with the arthritis, there is no urgency and doing the surgery. We can still do surgery later if you decide to do that and we can expect basically just as good an outcome. So, you really don't jeopardize anything by waiting. But if you are at that point where you're not able to do those things that you want to do, then that may be a time where you want to go ahead and look into that option of having the knee replacement.

What does the total knee replacement procedure involve?

I always think of a knee replacement as more of a resurfacing than a replacement. If we do a hip replacement, for instance, it's truly a replacement. We're putting a whole new ball in the hip and a whole new socket. But in a knee replacement, we're really only replacing the bearing surface, the cartilage, with a different surface. So that's why we call it a resurfacing. It's still relying on all the ligaments and the tendons and the soft tissues to hold everything together just like the native knee is held together.

What is the recovery process like after a total knee replacement?

The recovery after knee replacement is much more accelerated now than it used to be. We've learned that it's important to get people up and moving. It's actually not only better for them in general for their health after surgery, but also better for the knee. Patients tend to do better if you get the knee moving before there's a chance for the swelling and stiffness to set in. So again, the time in the hospital has decreased significantly over the years. We do the therapy really the day of surgery as soon as patients are back in their room. We will have them up full weight bearing, starting to walk around the room using a walker, starting to work on moving that knee. So it is a much more accelerated program. We try and get people back up and moving more quickly than was done in the past.