Patients who have severe knee arthritis in their 30s and 40s often develop this condition after suffering a meniscus or ACL tear followed by surgery. Even with treatment, degenerative changes can lead to significant pain and, particularly upsetting for younger individuals, reduced function. A partial knee replacement can be a tempting choice, but there are several options available to address this concern. Dr. John Hoffman, our board certified orthopaedic surgeon, explains the differences between two popular approaches: unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO).
A UKA is more popular and often better suited to an older patient. This procedure typically offers a shorter recovery and more pleasant healing experience compared to an HTO, which is part of what makes this procedure appealing for individuals of all ages. Furthermore, full weightbearing without support is possible after just two weeks post-op. However, this technique does require replacement of certain anatomical parts and the life of the implant is often shorter than that of the younger patient. As a result, people under a certain age will likely need another knee replacement surgery in the future, one that could be more complicated and risky as it requires removal of the first implant and placement of a new one. With older individuals, this is less likely to be an issue.
Another consideration that patients in their 30s and 40s should keep in mind is that an HTO often allows individuals to resume a wide range of activities, including high-impact sports that involve running and jumping. This type of recreation is advised against with a UKA or total knee arthroplasty (TKA), as it can lead to a shorter implant life or even implant failure. Advances in techniques and equipment have made UKA and TKA devices longer-lasting and more durable—many patients are able to return to walking, hiking, fishing, and skiing, for instance. Distance running, however, is still advised against, as well as more strenuous activities. Therefore, younger patients often benefit more from a HTO, even with a more demanding recovery.
Another procedure that can be used is the TVO – tibial valgus osteotomy. However, the TVO may not give as complete relief of symptoms as an arthroplasty (knee reconstruction). It typically helps with symptoms for 5-15 years.
Differences in lifestyle and biology may in fact favor a UKA or TKA for certain younger patients, and every treatment from our practice will be customized based on a broad array of factors. To learn more about these two operations, please talk to our skilled medical team.
Knee replacement surgery is designed to remove damaged and diseased bone and tissue and replace it with an implant that allows a patient to move comfortably again. Knowing what to expect before, during, and after the operation can help make the experience more pleasant. Our orthopaedic surgeon, Dr. John Hoffman, will discuss the details of your treatment plan with you prior to the surgery, and we encourage you to ask any questions and voice any concerns you may have during this meeting.
Before your knee replacement surgery, you will have a few instructions to follow. You may have to cease taking certain medications, and if you’re a smoker, you will need to stop using tobacco products for at least a month before the operation. Sometimes blood tests will need to be taken, usually about a week before the surgery. Your physician will tell you if this step is necessary. Additionally, you should not eat after midnight the day of your procedure.
Knee replacement surgery often can be performed at an outpatient ambulatory surgery center. This is possible due to a long-acting local anesthetic (the same type typically used by dentists for teeth). You should be able to return home the next day, and we will provide medication to manage your discomfort and to improve healing. Most patients report minimal pain, usually around a level one or two out of 10. Oral medication can help reduce this further.
The first week you will need to move around with the aid of a walker, and you can switch to a cane for the following few weeks. Once you can walk comfortably without a cane, usually two to four weeks after surgery, you should be able to drive again. Many patients can return to office work after about a month, individuals who spend long hours on their feet will likely need to wait up to eight weeks to return to full duty.
We want you to feel confident in your decision and comfortable in our hands, so please reach out to our medical team if you have any questions about what to expect from knee replacement surgery.
Surgery is a big decision, but it can be the right option for certain patients. If you can no longer do the things you love as a result of knee pain, if you have modified your lifestyle significantly to reduce discomfort in this area, you may wonder if knee replacement surgery is right for you. As a board certified orthopaedic surgeon, Dr. John Hoffman is extensively trained in total knee replacement. He performs approximately 600 total knee replacement procedures a year, and he has completed over 10,000 in his career. He is skilled in using minimally invasive techniques that can reduce healing time and minimize scarring. This rapid recovery approach can make knee surgery a more appealing option for some individuals.
One of the primary reasons to have knee replacement surgery is to maintain or return to higher activity levels. Some examples of common concerns include:
- Pain with long standing
- Pain when first getting out of a chair
- Limited ability to walk distances
If you feel that your freedom to enjoy life as you once did has been reduced due to discomfort, we can help you determine if total knee replacement is appropriate for your needs and goals. Function is an important part of enjoying an active, healthy, and happy life, and replacing a joint that no longer works can help patients regain the ability to participate in many activities.
Our skilled surgeons can provide guidance and advice to allow you to become as well-informed as possible. Talk to us today.