Bertram Total Joint Centers

Total Knee Workbook: Understanding Outcomes and Expectations

Read the information below and proceed to the end to complete the consent form.

Part 1: Understanding Outcomes and Expectations

Expected Activity

Your activities cannot be expected to greatly increase after this surgery. For example, if you play tennis now with pain, you should be able to play tennis after surgery with less pain. Allowed activities after TKR include walking, swimming, playing golf, playing doubles tennis. We do not recommend skiing, singles tennis, contact sports, jogging, or running. Kneeling will remain difficult.

I understand that my activities will not necessarily increase after TKR.

Pain Relief

Few TKR patients experience no pain whatsoever after the surgery. Indeed, most patients will have varying degrees of pain, depending upon their pain threshold. After all, you have had major surgery. An artificial knee is not the same as an original, healthy knee. Some patients will even have pain after surgery that cannot be explained. Conversely, many hip replacement patients can even forget, at times, that they have had a hip replacement; the artificial hip feels so natural. However, the mechanics of the knee are much more complex.

Complexity can be compounded if a patient has other health problems. For example, patients who have back problems may sometimes have continued unexplained or frustrating pain after knee replacement. Nerves that are irritated from the back problem can innervate the areas around the knee and lower leg.

Patients who have had previous knee surgery will have less likelihood of an excellent result. Neither can patients who have sustained severe injuries about the knee prior to surgery expect to have an excellent result.

You cannot expect to have a perfect knee after TKR. After all, the surgery has repaired a flawed joint, replacing it with an artificial joint; therefore, it cannot be the same as a natural, healthy knee.

I understand that my knee replacement will not feel like a normal knee.
I understand that I may have pain that persists after surgery.
I understand that my surgeon may be unable to explain continued pain.
I understand that patients with chronic back problems will sometimes have continued pain.

Typical Outcomes After Knee Replacement

You must remember that results of knee surgery depend upon the state of your knee before surgery. In other words, if your knee was in a very bad condition before surgery, your results will not be as good as someone whose knee was in better condition than yours. If your knee was in a bad condition, good--not excellent-- results are all you can hope to have. The earlier in the disease process that you have surgery, the better your outcome will probably be. In other words, someone with a mildly arthritic knee will probably be more satisfied with the result of surgery than someone who has had a severely arthritic knee prior to surgery. Keeping that in mind, your range of motion will not be significantly better after surgery than it was before surgery. Patients who have the surgery earlier in the disease process will have better range of motion after surgery. Patients who wait for years to do something about their knee problem will have less range of motion after surgery.¹²

According to statistics nationwide, 85% of patients having total joint replacement surgery will have a good to excellent outcome. Bear in mind: 85% is not 100%.¹¹

I understand that the worse my knee is before surgery, the more difficult it will be for me to have an excellent result. (Excellent meaning that the knee will have a nearly normal range of motion with little or no pain.)
I understand that 15% of patients undergoing this procedure will have a fair to poor result.

Joint Longevity

Most artificial knees will last from 15 to 20 years, but we cannot guarantee this longevity. Many factors are responsible for the life span of a knee replacement. These factors include the patient’s age or weight, activities undertaken after surgery, and the alignment of the prosthesis.

Sometimes mechanical failure beyond a surgeon’s control may happen, and if it does, revision surgery will be required.¹⁴

I understand that my knee replacement will probably last 15-20 years, but there is no guarantee of that.

Phone: 239-592-0373

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Naples Office: 1009 Crosspointe Drive, Suite 2 • Naples, FL 34110

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Marco Island Office: 973 North Collier Boulevard • Marco Island, FL 34145