Latest / The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement / Episode 119: Maintaining Your Knee Replacement for the Long Term (Activities, Follow-Up Care, and Changes Worth Checking)

Transcript

Episode 119: Maintaining Your Knee Replacement for the Long Term (Activities, Follow-Up Care, and Changes Worth Checking) · The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement

• 0:00
  Let me repeat that, about 82 out of every 100
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  total knee replacements remained in place without
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  revision surgery at 25 years. Are you ready to
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  get back to what you love after knee replacement?
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  The Total Knee Success podcast is your trusted
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  guide with practical tips, evidence -based strategies,
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  and no fluff. It's not personal medical advice,
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  just solid education to help you manage pain.
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  regain mobility, and get back to living the life
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  you love. Let's dive in. Welcome back to the
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  Total Knee Success Podcast. I'm Michelle. How
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  long will my knee replacement last? It's a frequently
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  asked question and the research gives us good
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  reason to think in terms of decades. Looking
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  after your replacement over those years includes
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  staying active, preparing for the things you
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  want to do, and knowing when a change needs to
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  be checked. By the end of this episode, you'll
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  have a better idea of how long knee replacements
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  often last, what the research says about activity
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  and longevity, and how to look after your knee
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  while getting the most use from it. In episode
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  118, we focused on an exercise routine. Today,
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  we're connecting that work to the years ahead.
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  A 2019 review by Evans and colleagues published
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  in The Lancet combined long -term studies and
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  National Joint Replacement Registry reports.
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  In the registry data, about 82 out of every 100
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  total knee replacements remained in place without
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  revision surgery at 25 years. Let me repeat that.
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  About 82 out of every 100 total knee replacements
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  remained in place without revision surgery at
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  25 years. Revision is an operation to replace
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  or change some or all of the replacement. That
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  figure counts replaced knees rather than individual
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  people. It describes implant survival, how long
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  the replacement remains without revision. Your
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  comfort and ability to do the things you enjoy
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  are also important parts of your result, and
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  those were separate from the outcome measured
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  by that statistic. 25 years is a research follow
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  -up point. Some people need another operation
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  sooner, while others continue using that same
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  knee replacement beyond the 25 years. This estimate
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  reflects people who had surgery many years ago
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  using the designs and techniques available then.
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  There are no guarantees and each person has their
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  own experience. Your age at surgery, medical
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  history, and the components used, as well as
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  any complications, help shape your individual
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  outlook. A 2025 study by Clement and colleagues
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  published in the Journal of Arthroplasty examined
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  registry data to estimate the chance of needing
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  revision over a person's remaining lifetime.
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  The estimates varied with age at surgery and
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  the design of the replacement. Younger people
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  generally had a higher estimated lifetime risk
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  and different designs also had different estimates.
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  If you'd like to look further into these studies,
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  take a look at the blog post for this episode
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  and you can see the references at the bottom
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  of the page. A lifetime estimate answers a different
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  question from the chance of needing another operation
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  within 10 years. Someone who has surgery at 50
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  has more potential years of use ahead than someone
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  who has it at 80. The study used statistical
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  estimates and did not assess why each person
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  needed a particular design or why revision occurred.
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  The results, therefore, cannot tell you that
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  one design is the best choice for everyone. Your
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  surgeon selects components to fit your anatomy
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  and surgical needs. For your own need, knowing
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  the date of surgery and having the details of
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  your replacement available can help if you later
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  see a different orthopedic practice. Those details
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  allow your clinician to interpret relevant follow
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  -up information for the components you actually
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  have. So what can you do to look after your replacement?
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  Staying active helps you maintain the physical
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  abilities you use every day. We have stronger
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  evidence for those benefits than for any particular
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  exercise habit, adding a specific number of years
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  to a replacement. A 2022 systematic review published
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  in The Knee looked at activity levels among 4
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  ,263 people who had undergone a total of 4 ,811
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  knee replacement procedures. Some participants
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  had both knees replaced, which explains why the
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  number of procedures was larger than the number
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  of people. Across the included studies, average
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  follow -up ranged from 4 to 12 years. People
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  who were more physically active did not have
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  a demonstrated increase in revision surgery compared
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  to those who were less active. The studies defined
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  activity differently, and their findings leave
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  uncertainty about individual sports and longer
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  periods of time. Being highly active can include
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  frequent walking or gardening. It does not necessarily
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  mean repeated running or jumping. Still, the
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  findings are reassuring for someone who wants
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  to continue moving and enjoying life with a knee
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  replacement. The American Academy of Orthopedic
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  Surgeons generally favors lower -impact recreation,
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  such as cycling and swimming, over high -impact
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  sports. Running, repeated jumping, contact sports,
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  and pursuits with a greater chance of falling
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  introduce different forces or injury risks. Recommendations
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  to limit those pursuits reflect concern about
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  wear, loosening, or injury, together with incomplete
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  long -term evidence. Research has not established
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  one reliable percentage increase in revengeant
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  risk for every sport or person. A 2024 review
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  by Tioli and colleagues examined research on
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  activity, sports, and the condition of knee replacements.
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  The authors found conflicting results across
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  studies. Some findings were reassuring for more
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  active people, while others raised concerns.
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  Research on particular high -impact sports remained
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  too limited to settle the long -term risk. Much
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  of this research observes what people choose
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  to do after surgery. More active participants
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  may also have better strength, fewer health problems,
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  or a more comfortable knee to begin with. Researchers
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  have to account for those differences when comparing
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  outcomes. An association between activity and
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  another operation cannot by itself establish
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  that the activity caused or prevented a need
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  for the operation. That uncertainty is a reason
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  to make a specific decision about a sport you
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  value. Ask what risks are known for that sport,
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  which concerns are based on limited evidence
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  or professional judgment, and whether changing
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  the intensity or style of play would fit your
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  circumstances. Your experience and preferences
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  can be part of that decision alongside your surgeon's
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  advice. Before starting or returning to a demanding
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  sport, discuss its specific demands with your
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  surgeon. Your prior experience, health history,
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  surgical history, and current abilities can influence
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  the recommendation. Follow any restrictions you've
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  been given. Preparing your body for what you
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  want to do is part of using your new knee well.
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  The 2026 Physical Therapy Guideline supports
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  progressive strengthening and training for balance
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  and walking after knee replacement. Adequate
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  knee motion also helps you perform the movements
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  your chosen pursuit requires. As the demands
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  increase, your preparation needs to reflect them.
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  Suppose you want to return to social dancing.
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  You may be comfortable walking around the neighborhood,
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  while moving backward, turning with a partner,
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  and continuing through several songs still need
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  practice. You can build toward those demands
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  with appropriate strength, balance, motion, and
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  gradually longer practice. A therapist can help
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  you assess what you need before you increase
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  the challenge. That preparation supports control
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  and participation. It cannot guarantee that an
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  injury will never happen or tell us exactly how
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  long your replacement will last. Along with staying
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  active, ongoing orthopedic care helps check how
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  your replacement is doing. wear or changes in
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  how the components are attached to your bone
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  can develop gradually. An examination and x -rays
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  can help your surgeon assess those changes, including
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  some that may produce few symptoms early on.
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  Follow -up is an opportunity to check the replacement
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  and discuss whether your knee is working comfortably
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  for what you do. There are different recommendations
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  for when to return. The American Association
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  of Hip and Knee Surgeons generally recommends
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  a visit every three to five years after the initial
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  post -operative period with the interval adjusted
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  to the person. The UK SAFE recommendations take
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  a different approach for selected people after
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  an uncomplicated first replacement. Routine visits
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  may be omitted between years 1 and 10 when the
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  components meet specified standards for a strong
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  track record and prompt orthopedic assessment
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  is available if symptoms develop. Those recommendations
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  include a clinical assessment and x -ray at 10
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  years with later review based on findings. People
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  with a more complex surgery or a previous revision
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  may need a different plan. Your surgeon can tell
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  you which schedule fits your circumstances. If
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  you've lost track of that plan, ask the office,
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  when would you like to see me again for my knee
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  replacement? Keep that plan available so you
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  know when to arrange your next visit. Between
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  visits, contact your doctor about new pain that
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  persists or increases, unexplained swelling,
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  giving way, or a noticeable loss in motion or
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  walking ability. Explain when the change started,
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  whether it settles or keeps getting worse, and
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  what has become harder to do. Several conditions
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  can cause similar symptoms, so an assessment
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  helps determine what's happening and what care
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  may help. That care may include another course
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  of physical therapy. You can return after your
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  original therapy has ended for a specific problem
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  with strength, knee motion, balance, or walking.
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  After evaluating your symptoms, your orthopedist
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  may refer you for treatment directed at those
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  limitations. I see people who have had knee replacement
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  and come back to therapy later because they're
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  still having difficulty with something they want
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  to do. We assess what's limiting them and work
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  on a plan that fits their needs. For more education
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  on pain, my book, Making Sense of Pain After
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  New Replacement, explains the topic in everyday
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  language. You'll find a link in the episode notes.
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  Some symptoms do need more urgent action. Infection
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  around a replacement is uncommon but can occur
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  even years after surgery. New or worsening pain
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  with redness, warmth, swelling, drainage, fever,
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  or chills calls for prompt medical evaluation.
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  Infection can occur without a fever, so seek
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  help based on the changes you're noticing. New
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  significant calf pain or swelling also needs
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  prompt medical assessment because a blood clot
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  is one possible cause. Sudden chest pain or shortness
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  of breath requires emergency evaluation. Knowing
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  which changes to report and having a follow -up
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  plan gives you a way to respond if a problem
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  develops. For day -to -day life, you can keep
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  building the abilities that support what you
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  enjoy. Many people use their knee replacements
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  for decades. Staying active, preparing for greater
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  demands, and getting help when something changes
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  can support those years of use. If you'd like
• 12:04
  ongoing information about living well after knee
• 12:07
  replacement, you can join the Total Knee Success
• 12:10
  insider newsletter. The link is in the episode
• 12:12
  notes. In episode 120, when other joints limit
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  your overall function after knee replacement,
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  We'll look at how your other knee, back, hip,
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  or ankle can affect your initial rehabilitation
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  and the things you do in later years. That will
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  conclude our series protecting your progress
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  for the long term. Thanks for joining me. I'm
• 12:33
  Michelle and this has been the Total Knee Success
• 12:35
  Podcast. This podcast is for educational purposes
• 12:42
  only. Discover more at TotalKneeSuccess .com
• 12:45
  and be sure to subscribe and share. because every
• 12:49
  step forward takes you closer to living the life
• 12:51
  you love.