Total Knee Replacement
What is Total Knee Replacement?
Knee replacement, also called knee arthroplasty, is a surgical procedure to resurface a knee. The knee procedure involves shaving a small thickness of damaged bone surface and cartilage from your thigh bone, shinbone and kneecap and replacing it with an artificial surface (prosthesis) made of metal alloys, & highly durable polyethylene.
Why would you need A Total Knee Replacement?
- To relieve severe pain caused by Osteoarthritis, Rheumatoid arthritis and arthritis that results from a knee injury
- If nonsurgical treatments like medications and using walking supports are no longer helpful
- If you have severe knee pain or stiffness that limits everyday activities including walking, climbing stairs, and getting in and out of chairs
- Moderate or severe knee pain while resting, either day or night
- Chronic knee inflammation and swelling that does not improve with rest or medications
- Knee deformity, bowing in or out of your knee
- Failure to substantially improve with other treatments such as anti-inflammatory medications, cortisone injections, lubricating injections, physical therapy, or other surgeries
How Do You Prepare for a Total Knee Replacement?
You will undergo different tests beforehand to ensure you are healthy enough for the procedure. These will include:
- Blood Tests.
- A review of your medical history.
- A physical examination. This will assess knee motion, stability, strength, and overall leg alignment.
- X-rays. These images help to determine the extent of damage and deformity in your knee.
- Other Occasionally blood tests, or advanced imaging such as a magnetic resonance imaging (MRI) scan, may be needed to determine the condition of the bone and soft tissues of your knee.
Our team will provide you with a complete set of instructions about preparing yourself for surgery. These can include:
- Not eating or drinking anything before the surgery for 8 hours or more
- Having someone to stay with you immediately after surgery
- Your doctor might ask you to stop taking certain medications and supplements
- Arrange for a ride home
Before the procedure
You first change into the hospital gown. Our nurse inserts an IV line for injecting medication and fluids through your vein.
You will be given an intravenous antibiotic before, during, and after the procedure to help prevent post-surgical infection.
You might also be given a nerve block around your knee to numb it. The numbness wears off gradually after the procedure.
You may be put under general anesthesia, which means you will not be conscious before and during the surgery or under spinal anesthesia, which leaves you awake but unable to feel pain from your waist down.
During the procedure
Your knee will be in a bent position to expose all surfaces of the joint. After making an incision about 6 to 10 inches long, your surgeon moves aside your kneecap and shaves the damaged joint surfaces.
After preparing the joint surfaces, the surgeon attaches the pieces of the artificial joint. Before closing the incision, he or she bends and rotates your knee, testing it to ensure proper function. The surgery lasts about one to two hours.
There are four basic steps to a knee replacement procedure.
- Bone preparation: The damaged cartilage surfaces at the ends of the thigh bone and shin bone is shaved along with a small amount of underlying bone.
- Implant sizing and positioning: The shaved cartilage and bone are replaced with metal components that are correctly sized to recreate the joint These metal parts may be cemented or “press-fit” into the bone.
- Kneecap resurfacing: The undersurface of the patella (kneecap) is cut and resurfaced with a polyethene button.
- Tibial insert: A highly resistant polyethene spacer is inserted on the shinbone between the metal components to create a smooth gliding surface
After the procedure:
You are brought to the recovery room until you recover from anesthesia, and your vital signs are closely monitored the entire time.
You will be encouraged to move your foot and ankle, which increases blood flow to your leg muscles and helps prevent swelling and blood clots.
You will likely receive blood thinners and wear support hose or compression boots to further protect against swelling and clotting.
You will be asked to do frequent breathing exercises and gradually increase your activity level.
The day after surgery, a physical therapist will show you how to exercise your new knee. After you leave the hospital, you will continue physical therapy at home or a center.
The report of the procedure, discharge medications and follow up appointment details will be provided to you at the time of discharge.
Do your exercises regularly, For the best recovery, follow all your care team’s instructions concerning wound care, diet and exercise.