Our Summary

This study looks at the differences in outcomes for patients who had total knee replacement surgery performed by both experienced surgeons and those still in training over a ten-year period. The research involved 686 patients, with about two-thirds of surgeries performed by experienced surgeons and one-third by trainees. The study looked at factors such as how long patients stayed in the hospital, how well the knee replacement parts held up, how well the knee functioned, and patient mortality. The results showed that there were no significant differences in these outcomes between surgeries performed by experienced surgeons and those performed by trainees. In other words, patients had similar results whether their surgery was done by an experienced surgeon or a trainee.

FAQs

  1. Did the study find any significant differences in outcomes between knee replacement surgeries performed by experienced surgeons and those performed by trainees?
  2. What factors did the study assess in comparing knee replacement surgeries performed by experienced surgeons and trainees?
  3. What percentage of the knee replacement surgeries in the study were performed by trainees?

Doctor’s Tip

A helpful tip a doctor might give a patient about knee replacement is to follow a proper rehabilitation program after surgery. This includes doing exercises to strengthen the muscles around the knee, following the prescribed physical therapy program, and gradually increasing activity levels as advised by the healthcare team. This will help improve mobility, reduce stiffness and pain, and speed up the recovery process. It is important to be patient and consistent with the rehabilitation program to achieve the best possible outcome after knee replacement surgery.

Suitable For

Patients who are typically recommended for knee replacement surgery are those who have severe knee pain that limits daily activities, stiffness in the knee that makes it difficult to bend or straighten, chronic inflammation or swelling in the knee, knee deformity, or knee instability. These symptoms are often caused by conditions such as osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, or avascular necrosis. Patients who have not experienced relief from conservative treatments such as medication, physical therapy, or injections may also be candidates for knee replacement surgery. Additionally, patients who have tried less invasive procedures such as arthroscopy or osteotomy without success may also be recommended for knee replacement surgery.

Timeline

Before knee replacement:

  1. Patient experiences chronic knee pain, stiffness, and swelling that limits their mobility and quality of life.
  2. Patient consults with an orthopedic surgeon to discuss the possibility of knee replacement surgery.
  3. Surgeon conducts a thorough evaluation of the patient’s knee, medical history, and overall health to determine if they are a suitable candidate for surgery.
  4. Patient undergoes pre-operative testing and preparation, which may include physical therapy, blood tests, and imaging studies.
  5. Patient and surgeon discuss the risks and benefits of knee replacement surgery and develop a treatment plan.

After knee replacement:

  1. Patient undergoes knee replacement surgery, during which the damaged knee joint is replaced with an artificial implant made of metal and plastic.
  2. Patient spends several days in the hospital recovering from surgery and receiving physical therapy to regain strength and mobility.
  3. Patient continues physical therapy and rehabilitation at home or in a rehabilitation facility to improve range of motion and function of the new knee joint.
  4. Patient gradually resumes daily activities and may require assistive devices such as a cane or walker for support.
  5. Patient follows up with their surgeon for post-operative appointments to monitor healing, address any complications, and assess the long-term success of the knee replacement.
  6. Patient experiences improved mobility, reduced pain, and increased quality of life as a result of the knee replacement surgery.

What to Ask Your Doctor

  1. How many knee replacement surgeries have you performed?
  2. What is your success rate with knee replacement surgeries?
  3. What are the potential risks and complications associated with knee replacement surgery?
  4. How long is the recovery process and what can I expect during the rehabilitation period?
  5. What type of knee replacement implant will be used and why is it recommended for my case?
  6. How long do knee replacement implants typically last?
  7. Are there any alternative treatments or therapies that I should consider before opting for surgery?
  8. Will I need physical therapy after the surgery, and for how long?
  9. How soon can I expect to return to my normal daily activities and exercise routine?
  10. What measures can I take to ensure the best possible outcome after knee replacement surgery?

Reference

Authors: Faulkner A, Reidy MJ, Davies PSE, Wang W, Buddhadev N, Johnston L, Clift B. Journal: Surgeon. 2018 Aug;16(4):227-231. doi: 10.1016/j.surge.2017.10.003. Epub 2017 Dec 13. PMID: 29248360