Total Knee Replacement

What is Total Knee Replacement?

This surgical procedure requires replacing a damaged or diseased knee joint with a synthetic material. During the procedure, the end of the femur bone is surgically removed and replaced instead with a hard metal shell.

Knees damaged by severe arthritis or injury can cause pain during normal activities like walking, and eventually it becomes painful to even sit or lie down. When medications and walking supports are no longer providing relief, total knee replacement surgery may be your best option to restore normal function and relieve pain. The surgery can also correct painful leg deformities by resurfacing the damaged areas.

The Procedure

Before the surgery begins, the patient is first moved to the operating room and placed under general anesthesia. The skin surrounding the knee is then scrubbed thoroughly using an antiseptic. The knee is flexed and the lower area of the leg is placed into a device to hold it securely. A tourniquet is typically applied to the upper leg to slow blood flow and in incision is made in the leg.

Damaged Bone is Removed

Next, damaged surfaces and cartilage are carefully removed by the doctor using guides and instruments to ensure the cuts are made at exact angles. This allows the new implants to attach properly.

Portions of bone are removed from the top of the femur and used to shape the bone so the new implant may fit in well. The amount removed depends mostly on the level of damage. The top surface of your tibia bone may also be removed to make the end flat, while the back of the patella (the kneecap) will be removed.

Implant Attachment

The next stage of the operation is the attachment of the implant, which is attached to all three bones in the leg. These synthetic implants are designed to move like a healthy joint and attach with a form of cement.

The part of the implant that goes over the femur is constructed from metal with a smooth, rounded surface. The portion that fits over the tibia bone has two parts: a metal baseplate and a plastic surface that acts as a spacer. The part of the implant behind the patella is also constructed from a durable type of plastic.

There are many artificial knee implant designs, some of which require small holes to be drilled in the bone. Some also use screws for additional security. Your surgeon will choose the design that best meets your unique needs.

Wound Closure

Finally, ligaments around the knee are adjusted for the best function and the tissue is sewn back into position. A thin plastic tube is often installed in the wound so liquids may drain shortly after surgery.

Recovery from Total Knee Replacement Surgery

Ten-year survival rates for knee replacements currently range anywhere from 90 to 95%, although success depends greatly on following your surgeon’s instructions after surgery. Your doctor will give you detailed instructions regarding wound care, diet, and activity.

General wound care requires avoiding soaking the would until it’s completely dry and sealed. Loss of appetite is normal for many weeks post-surgery, although a balanced diet is important to encourage healing and restore strength. You should be able to return to your normal level of activity within three to six weeks post-surgery, although pain will be common for the first few weeks. Adopt a graduated walking program and work with a physical therapist to restore movement and strength.