Total Knee Replacement

Total knee replacement may be an option for patients with severe knee arthritis that has forced them to alter their daily lives or avoid certain activities. Total knee replacement has been done for over 50 years, and the techniques, implants, and surgical instruments have evolved considerably during that time to improve results for patients.

Dr. John Coen, a board certified orthopedic surgeon, has done total knee replacements for nearly 25 years. He performs a high volume of both primary and revision total knee replacements, averaging 200-300 every year. New technologies, like robotic assisted surgery, are becoming more popular, and Dr. Coen now routinely performs robotic assisted total knee replacements at two of the three facilities where he performs surgery. Since research does not show a clear advantage to these systems, he believes skill level and experience are still the most important factors in selecting a total knee replacement surgeon.

Candidates for Total Knee Replacement

Candidates for total knee replacement have severe arthritis of the knee that affects everyday life. Knee arthritis is initially treated with nonsurgical methods like anti-inflammatory medications, injections, and physical therapy. However, if a patient still has significant pain and disability in their daily life, total knee replacement may be considered.

If a patient is experiencing any of the following symptoms, it may indicate that he or she would be a good candidate for total knee replacement:

• Severe knee pain or stiffness caused by arthritis that limits everyday activities
• Difficulty performing simple tasks like walking, climbing stairs, kneeling, standing, or sitting due to knee pain
• Knee pain that continues even while at rest
• Chronic swelling and inflammation in the knee
• Knee deformity due to bone-on-bone arthritis

Total Knee Replacement Procedure

Dr. Coen performs the majority of total knee replacements in an outpatient surgery center. This allows patients to return home the same day to recover in the comfort of their own homes. Preoperative education ensures that patients and their caregivers are well-prepared to navigate recovery at home.

During a total knee replacement procedure, Dr. Coen removes the damaged bone and cartilage in the knee, replacing them with metal implants. A plastic spacer is inserted between the two metal components to allow for smooth movement when bending and straightening the knee.

Due to his vast experience with knee replacement, Dr. Coen is able to put the implants in place with a high degree of accuracy. However, he cautions patients that dedication to the recovery process is of utmost importance for the overall success of total knee replacement.

Recovering from Total Knee Replacement

Dr. Coen always tells patients that surgical skill only accounts for about 20% of the success of a total knee replacement. The other 80% relies on the patient’s dedication to and support in the recovery process. Though physical therapy and exercise are an important part of any joint replacement procedure, they are particularly important for the outcome of knee replacements.

Movement is very important in recovering from knee replacements, as the knee can get stiff without regular movement. Patients will work with a physical therapist to learn exercises, but must also commit to doing the exercises 3 times a day at home for 3 months.

The goal of a total knee replacement is to allow patients to do what they want without their knee bothering them, so full recovery can vary depending on the patient’s activity goals. Generally, patients should be able to walk without an assistive device within 3-4 weeks of surgery and resume most of their daily routine within about 6 weeks. Within about 3-4 months, most patients are back to about 80% of their normal activities. However, even with full commitment to the exercise program, it generally takes about a year to see full improvement after a knee replacement because it takes time to rebuild stamina and endurance in the knee or leg.

Knee replacements can last for as long as 20 years. Patients do tend to be more aware of a knee replacement as compared to a hip replacement. Occasionally, the knee implant will click or pop, and it can be felt while kneeling since the front of the knee is pressure-sensitive. This is normal for knee replacement. However, in exchange for these minor complaints, patients can enjoy their favorite activities for many years without having to worry about arthritis pain.

Total Knee Replacement in Tualatin & Oregon City, OR

Dr. John Coen is a board certified orthopedic surgeon with 25 years of experience in joint replacement procedures like total knee replacement. Dr. Coen is a high-volume knee replacement surgeon, performing hundreds of primary and revision total knee replacements every year. He also believes in preoperative education to help prepare patients for the recovery process. If you would like to schedule an appointment with Dr. Coen, please call our office at (503) 656-0836 or request an appointment online.

---