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A New Lease on Life

What You Need to Know About Total Knee Replacement

For those suffering from chronic knee pain, total knee replacement surgery is often a life-changing solution, offering pain relief and restored mobility. Recently, we sat down with experienced orthopedic surgeon Dr. Uday Patel, who is leading the newly developed Center for Orthopedics & Sports Medicine at CalvertHealth, to discuss the procedure, recovery and what patients can expect from this transformative surgery.

Q: How do I know if I need a total knee replacement?

Dr. Patel: The knee contains cartilage that cushions the joint, but over time, this cartilage can wear down due to normal aging, injury, obesity or arthritis. When this happens, patients often experience pain, swelling and even deformity in the knee. While some discomfort is manageable, if knee pain begins to interfere with your daily activities—such as walking, climbing stairs, traveling or exercising—it may be time to consider knee replacement surgery.

Q: What are the risks associated with knee replacement surgery?

Dr. Patel: Like any major surgery, there are risks, but they are rare. The two biggest concerns are infection and deep vein thrombosis (DVT), also known as blood clots. Fortunately, advancements in surgical techniques and infection prevention— such as IV antibiotics, surgical spacesuits and specialized sterilization methods—have significantly reduced these risks. For blood clot prevention, most patients take aspirin after surgery, while higher-risk individuals may require a stronger anticoagulant.

Q: What makes your approach unique?

Dr. Patel: While IV antibiotics before, during and after surgery are standard practice, I take additional precautions to minimize infection risk. I use double-glove techniques, change gloves multiple times during surgery, apply antibiotic powder in the bone cement, wrap the knee with an antiseptic wrap during surgery and thoroughly wash the joint before closure. In my 23 years of performing joint replacements, I’m proud to say I have not experienced a single infection directly after knee replacement surgery.

Q: How long does the surgery take, and what is the recovery process like?

Dr. Patel: The surgery itself takes about 90 minutes, with an additional three hours in recovery. Most patients can return home the same day. Remarkably, patients are allowed full weight-bearing without the use of a brace immediately, meaning they can stand and walk with assistance right away. The most significant pain typically lasts about two weeks, but 90% of recovery occurs within the first three months. Many patients can return to office work in about six weeks.

Q: How is pain managed after surgery?

Dr. Patel: We use a combination of pain management strategies, including spinal anesthesia, localized injections that last 48-72 hours, and a mix of oral and IV medications. This multimodal approach allows patients to recover comfortably at home with reduced reliance on narcotic pain medications. Patients are advised to use ice as much as possible when resting, especially in the first few weeks after surgery.

Q: What kind of follow-up care can patients expect?

Dr. Patel: After surgery, patients receive physical therapy at home for the first three weeks. They also have follow-up appointments in the office at two and six weeks post-surgery. After that, most patients only require annual or biannual checkins to monitor the knee’s condition. As part of rehabilitation, most insurance providers approve a home exercise bicycle designed to improve knee flexibility. This specialized bike is delivered to the patient’s home, and the company handles both drop-off and pick-up. The bike adjusts to accommodate limited movement initially and gradually increases range of motion over time. Additionally, it includes Bluetooth tracking, allowing me to monitor patient progress and provide guidance as needed. It’s a key tool in ensuring a smooth recovery.

Q: What are the long-term expectations for a knee replacement?

Dr. Patel: A knee replacement typically lasts between 15-20 years, depending on factors like patient weight and activity level. To maximize the lifespan of the implant, patients should avoid high-impact activities like running or prolonged kneeling.

Q: When can I resume normal activities, like driving or traveling?

Dr. Patel: If the surgery was on the left knee and you drive an automatic, you can resume driving in about two weeks, as long as you are off narcotic medications. If it was the right knee, you’ll need to wait about six weeks to ensure you can safely perform emergency braking. For air travel, we recommend waiting at least four weeks due to the risk of blood clots associated with flying.

Q: What’s your philosophy when it comes to patient care?

Dr. Patel: My goal is to provide meticulous surgical care and comprehensive follow-up to ensure the best outcomes. This is a journey, and I take pride in guiding my patients every step of the way. Through advanced techniques, personalized pain management and thorough post-surgical monitoring, I strive to make total knee replacement as seamless and successful as possible.

MEET THE EXPERT

Board-certified orthopedic surgeon Dr. Uday R. Patel has joined CalvertHealth Medical Group, bringing more than 20 years of experience in orthopedic surgery. He earned his medical degree from Albert Einstein College of Medicine and completed his internship and residency at New England Medical Center. Dr. Patel is now leading the newly established CalvertHealth Center for Orthopedics & Sports Medicine, located in the Calvert Medical Arts Building on the Medical Center campus. The center offers in-office X-rays and is adjacent to CalvertHealth Outpatient Rehabilitation, providing patients with convenient access to comprehensive orthopedic care and physical therapy services. To learn more or to schedule an appointment, please visit calverthealthmedicine.org/center-for-orthopedics-sports-medicine or call 410.846.8800.
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