You should strive to get the Best Total Knee Replacement you can.It always surprises me how many of my patients wait to fix their knees because they have heard that “total knees don’t last too long”. Actually, the results of my knee replacements keep getting better and better. The reasons are better materials, better implants, better techniques, better pain management, and better understanding of the rehab process needed. For instance, I have found that waiting a week before starting painful flexion exercises helps decrease initial bleeding and swelling and pain, and results in a faster recovery – possibly the opposite of what you might expect. In the end, the knee replacement surgery is another form of a “controlled trauma”, and some initial healing goes a long way towards faster recovery. We also flex our knees over a pillow the first night of surgery. I was taught to avoid this because “it would make it harder to get the knee straight”. Not true! The flexed knee is more comfortable, particularly when using a femoral nerve block to control pain, as it relaxes the posterior ligaments. It also has the added benefit of stopping any residual bleeding in the knee ( indirectly by tensing the soft tissues – the bleeding stops!).
Using a spinal anesthesia also greatly reduces the mental perception of pain, as the pain returns gradually after surgery, giving the mind time to accommodate and generate your own endorphins which are ( morhpine like substance that your body creates when it senses trauma or pain). The spinal is so much SAFER than a general anesthesia, because you continue to breathe on your own, without the need for paralytic medications and a machine to breathe for you through a tube. The bottom line is – there is more to the success of a knee replacement then the surgery itself. You need to find a qualified expert – just like you would for any important procedure you might want to have done – Ask your surgeon if he has done a Joint Replacement Fellowship, and how many joints a year he does. Expert total knee surgeons will do over 100 procedures a year, and their results have been shown to be better ( practice makes perfect! ). Dr. Kozinn has been doing 200 to 300 total knees a year for over 20 years – now that is called : EXPERIENCE !