Pre-Surgery

Assessment of the Severity of Arthritis

At our initial office visit, we will assess the severity of your limitations and disability based on your history, physical examination, treatments, and a review of your radiographs. You will answer questions on an iPad that compute patient reported function scores including the Oxford Knee Score. These scores are used to measure the severity of your knee arthritis before surgery and the pace of your recovery after the surgery. We will educate you about kinematically aligned total knee replacement and what to expect after the surgery.

Design and Material of a Total Knee Replacement

In the office, you will examine a life-size model of a normal knee and a knee with the implants used to replace your knee. The femoral and tibial implants are made of stainless steel and high-density polyethylene plastic. They are cemented onto the bone like a dentist cements a crown on a tooth. A plastic button is cemented on the underside of the knee cap (not shown). The cement quickly sets in 10 minutes, which enables the patient to put full weight and walk on their knee within an hour after surgery.

Because the implants are made of plastic and metal, they may click or make noise when they contact each other. The noise becomes much less frequent when swelling subsides. When you hear clicking, don’t be concerned as it is NOT a sign of loose implants.

Poor Function and Pace of Recovery as Measured by the Oxford Knee Score

The Oxford Knee Score asks 12 questions that assess patient function before and after total knee replacement. 20 points is the average score for patients before total knee replacement. 48 points is the score of a normal knee. Patients with a 25 point or lower Oxford Knee Score often benefit from a total knee replacement.

The pre-operative Oxford Knee Score helps predict and assess the pace of recovery after knee replacement. At four to five weeks, recovery is 50% with an average Oxford Knee Score of 29, which is 9 points better than before surgery. Most patients are walking without a cane and driving their car 15. At three months, recovery is 70% with most patients engaging in recreational activities such as gardening, tennis, golf, biking, bowling, and hiking. At six months, recovery is 90% with an average Oxford Knee Score of 42, which is 22 points better than before surgery.

The process for undergoing total knee replacement can be broken down into several steps, which includes preparing for knee replacement surgery, care the day of surgery, care in the hospital after surgery, and care at home that enables rapid recovery.