Knee replacement surgery

What is knee arthroplasty?

Knee replacement surgery, also referred to as knee arthroplasty, is a surgical procedure aimed at replacing either the damaged portion or the entire knee joint with an artificial joint called a prosthesis. This procedure falls under the category of arthroplasty, where the surgeon removes the affected parts of the natural knee joint and replaces them with a carefully crafted artificial joint made of metal and plastic materials.  

Who performs knee arthroplasty?

Knee arthroplasty is performed by specialized orthopaedic surgeons who have undergone extensive training and gained substantial experience in treating various joint diseases, including knee joint disorders. Knee arthroplasty is conducted in a hospital setting, specifically in an operating room equipped with the necessary surgical instruments and equipment.

There are two primary types of knee replacement surgeries.

  • Total Knee Replacement: Total knee replacement is the more prevalent procedure involving the replacement of all three areas of the knee joint: the medial (inside), lateral (outside), and patellofemoral (under the kneecap). This comprehensive approach is recommended for individuals with extensive knee joint damage caused by osteoarthritis or rheumatoid arthritis.
  • Partial Knee Replacement: As the name suggests, a partial knee replacement focuses on replacing only certain areas of the knee joint. It is typically chosen when only one or two parts of the knee are damaged, making it suitable for younger adults who have experienced specific injuries or traumas.

When knee replacement surgery is recommended?

Knee replacement surgery is considered when conservative treatments, such as medications, physical therapy, and lifestyle modifications, no longer provide sufficient relief for knee pain and impaired function. Common indications include:

  • Severe osteoarthritis or rheumatoid arthritis with restricting everyday activities like walking, climbing stairs, and sitting down or standing up from chairs. Individuals with significant pain while walking even short distances necessitating the use of a cane or walker.
  • Post-traumatic arthritis due to injury or fracture
  • Persistent knee inflammation and swelling
  • Knee deformity – an inward or outward bowing of the knee.
  • Failure of previous knee surgeries

How is a knee replacement procedure done?

Preparing for surgery

Before undergoing knee replacement surgery, the doctor will guide the patient through the preparation process, which may include:

  • Physical examination to assess overall health and identify potential risks
  • Blood tests and imaging tests, including knee X-ray, magnetic resonance imaging (MRI), or computed tomography (CT) scan, to evaluate the extent of knee damage
  • An electrocardiogram is conducted to assess the health of the heart.
  • A dental examination is performed to minimize the risk of infection following surgery.
  • Inform the doctor about all the medications and over-the-counter supplements currently being taken. Certain medications or supplements may need to be discontinued before the surgery.
  • The doctor/surgeon will provide specific instructions regarding the timing for discontinuing food and drink intake before the procedure. In general, most individuals are required to refrain from eating or drinking anything for 12 hours before their scheduled surgery.
  • A written consent form is typically signed by the patient or their family member after they have been provided with information about the surgery.

During surgery

Anesthesia will be administered to ensure that the patient is pain-free. An anaesthetist will administer either general anesthesia, which puts the patient to sleep throughout the surgery, or regional anesthesia, which numbs the lower part of the body from the waist down. The anesthesia team will decide which type of anesthesia is best for the patient.

During the knee replacement surgery, the surgeon will perform the following steps:

  • The surgeon will carefully remove the damaged cartilage and bone from the affected areas of the knee joint.
  • Specialized artificial metal and plastic components will be placed precisely to replace the removed cartilage and bone. These components form the new knee joint.
  • A plastic spacer will be inserted to recreate the smooth cushioning function of the original cartilage, providing a gliding surface within the newly formed joint.
  • If necessary, the undersurface of the kneecap will be reshaped to ensure proper alignment and fit with the new prosthetic knee joint.

After surgery

After knee replacement surgery, the patient will be monitored in the recovery room until vital signs stabilize. The patient will be taken to the hospital room once the vitals (pulse, blood pressure) are stable. Typically, knee replacement surgery requires a hospital stay of several days.

Early mobilization is crucial, and a physical therapist will design an exercise program for the patient shortly after surgery. Pain medication will be provided to ensure comfort during exercises.

After discharge, the patient will continue physical therapy at home or in a rehabilitation center to regain muscle strength and improve range of motion.

The patient may require crutches or a walker temporarily to support walking and balance.

The surgeon and team will provide guidelines for wound care, medication management, and home exercises.

Regular follow-up appointments with the surgeon are essential to monitor recovery progress and address any concerns.

While knee replacement surgery is generally safe, it does carry some risks and potential complications. These may include:

  • Infection at the surgical site
  • Blood clots
  • Implant-related complications, such as loosening or dislocation
  • Nerve or blood vessel damage
  • Stiffness and reduced range of motion
  • Allergic reactions to anesthesia or implants

Contact the doctor immediately if experience any of the following symptoms:

  • Chest pain.
  • Shortness of breath (dyspnea).
  • Fever exceeding 101° F.
  • Signs of infection at the surgery site include leaking, swelling, discoloration, odour, or warmth.
  • New or worsening pain in calf, ankle, or foot.
  • Persistent severe pain that does not improve with pain medication.

Knee replacement surgery typically offers significant pain relief, increased mobility, and improved quality of life for the majority of patients. In many cases, knee replacements can last for at least 15 to 20 years, providing long-term benefits.

Following a successful recovery, individuals can engage in various low-impact activities, such as walking, swimming, golfing, or biking, which can help maintain an active lifestyle. However, avoiding higher-impact activities like jogging or sports involving jumping or contact is advisable. For personalized advice on staying active after knee replacement, it is essential to consult with a doctor. They can provide guidance and recommendations tailored to your specific condition and recovery progress.


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