These knees are made for dancing

The truth is that artificial knees, while certainly an improvement over severely arthritic, are not like normal, healthy knees. There are limitations inherent in the devices and surgical techniques that most surgeons use. Although a vast majority of patients ultimately fare really well, in some cases the device fails or there are lasting injuries to internal tissues.

Studies of many hundreds of patients with total knee replacements show potential problems surgeons may fail to mention in advance. “What we as health professionals tell patients preoperatively isn’t always what they need to know,” Ann F. Jacobson of the Kent State University College of Nursing said in an interview.

Managing Expectations

Dr. Jacobson and her colleagues studied the preoperative and short-term postoperative experiences of 27 patients undergoing total knee replacements. Writing in the May issue of The American Journal of Nursing, they concluded, “Patients need to be better educated and supported before and after total knee replacement surgery.”

The researchers found that many people delayed the surgery for months, even years, “despite increasing pain and limitation” and difficulty maintaining their independence. Postoperatively, the main issues for patients were pain, difficulty with the activities of daily living, and the time it took to recover their independence.

“Patients really struggled with having to be a bother to others,” Dr. Jacobson said. “They need help beforehand in learning to let go temporarily of their independence and accept the fact that they’ll need help after the surgery.”

Perhaps the study’s most important finding is that patients are often told that they will be at a certain level of recovery in a certain length of time, which often leads to unrealistic expectations, Dr. Jacobson said, adding, “Everyone heals differently, and there’s no one prediction that can apply to all patients.”

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