A total knee replacement is performed by replacing worn away cartilage in the knee with an artificial implant made of metal and plastic parts. This restores function in the knee by reducing the pain of bone rubbing on bone so the patient can return to activities of daily living.
Overview of procedure
- A 3-4 inch incision is made on the front of the knee
- The bone is prepared by removing damaged cartilage surfaces on the ends of the femur and tibia along with a small amount of bone
- The surgeon will position the metal implants in place where the damaged cartilage and bone was removed, recreating the joint surface.
- These metal parts are cemented in place or “press fit” into the bone.
- The underneath surface of the patella is cut and resurfaced with a plastic button
- A plastic spacer is inserted between the metal surfaces of the resurfaced bones to create a smooth gliding surface
- The patient is taken to a recovery room and then to their in-patient hospital room
- The total surgery takes approximately 1-2 hours to complete
Pre-treatment considerations
- A total knee replacement is advised for those with severe arthritis that negatively impacts their normal activities of daily living
- Advised for severe osteoarthritis, rheumatoid arthritis, and post traumatic arthritis
- Usually advised for those between the ages of 50 and 80. However, pain and disability, not age, should determine if this treatment is advised.
- Different implants are used to meet individual needs
Post-treatment considerations and recovery
- The patient will be taken to their hospital room after they have recovered in the recovery room
- A normal hospital stay after a total knee replacement is 1-3 days.
- Medications are given to relieve surgical pain and to thin blood in order to prevent blood clots.
- Physical therapy is begun the day after surgery with a continuous passive motion machine.
- Physical therapy is gradually increased until the patient can walk on their own. Once the patient can walk on their own and eat normal food they will be discharged.
- The patient will be discharged with crutches to help with walking. They should remain in the crutches for the first 2-3 weeks, only putting weight on the surgical leg during supervised physical therapy.
- The first follow up appointment is approximately 2 weeks later in which the staples from surgery will be removed.
- The next appointment will be approximately 6 weeks after surgery
- Physical therapy will take about 3 months.
- Time to return to normal activity would be approximately 1-3 months depending on level of activity.
Pros and benefits
- Reduction in knee pain
- Significant improvement in ability to perform activities of daily living
Cons, risks, and possible side effects
- Prosthesis (the metal implant and spacer) can loosen or wear down over time, especially with excessive weight or excessive activity
- Infection
- Heart attack or stroke
- Excessive bleeding or blood clots
- Implant issues
- Continued pain
- Neurovascular issues
- Stiffness or a limp
- Leg length discrepancy
- Delayed healing of bone and soft tissue
- Extra bone formation
- Inflammation of leg veins
