Total knee replacement (total knee arthroplasty) surgery replaces parts of the knee joint with artificial (prosthetic) parts.
A major operation (major surgery) is one that usually involves opening the body, major trauma to the tissues, an increased risk of infection, and a longer recovery period. Most major operations will leave a large scar.
A total knee replacement is considered a major operation, and may be indicated when other treatments (weight loss, exercise and physical therapy, medications, injections, and bracing) have failed to relieve the pain, which must be significant and disabling.
Total knee replacement is usually used:
- To relieve pain caused by severe arthritis
- To restore function to an arthritic knee
- To correct a significant deformity
- For severe patellofemoral arthritis (rarely used for this condition)
- Candidates for knee replacement surgery include those who have:
- Severe pain, swelling and stiffness in the knee joint and whose mobility is reduced
- Knee pain is so severe it interferes with quality of life and sleep
- Extreme difficulty with everyday tasks and activities
- Depression due to pain and lack of mobility
- Inability to work or have a social life due to pain and lack of mobility
Patients also need to be well enough to manage both a major surgery and the rehabilitation afterwards.
About 82% of total knee replacements last 25 years and can be affected by a patient’s activity levels. The procedure is usually reserved for older patients who perform modest activities or younger patients with limited function due to severe arthritis.
How Do Doctors Perform Knee Replacement?
Total knee replacement is a surgical procedure performed under regional or general anesthesia.
A knee replacement procedure is as follows:
- An incision is made in the front of the knee
- The lower part of the upper leg bone (distal femur) and the upper part of the lower leg bone (proximal tibia) are cut and removed
- The ends of the bone are altered so a knee replacement prosthesis is able to be attached in the ideal position
- The proper functioning of motion in the knee replacement is assessed and the prosthesis is cemented into place
- The incision is sutured and the knee is bandaged and braced
A total knee replacement surgery takes about two to three hours and patients are usually in recovery with observation for 6-24 hours.
After surgery, patients are:
- Given pain medications and cryotherapy to reduce postoperative swelling and pain
- Encouraged to walk on the second day following the surgery
- Usually supervised by a physiotherapist until discharge
What Is the Recovery Time for a Knee Replacement?
Many factors determine how long it can take to recover from a total knee replacement.
- Patients are generally discharged from the hospital within 1-7 days following knee replacement surgery.
- Short-term recovery, in which a patient can walk with minimal aid or no aid and only needs over-the-counter pain relief typically happens within twelve weeks after surgery, and most patients are able to fully return to normal activities within three to six months.
What Are Risks and Complications of Knee Replacement?
Complications of knee replacement surgery include:
- Stiffness
- Persistent pain
- Blood clot in the deep veins of the leg (called a deep vein thrombosis or DVT)
- DVT can be deadly if it travels to the lungs (called a pulmonary embolism) so see a doctor if you have symptoms that could indicate a DVT, such as leg pain or swelling
- Infection
- Fever
- Chills
- Pain in the knee that gets worse suddenly
- Increasing redness
- Swelling
- Early failure of the implant
- Need for revision surgery if knee replacement is performed on patients younger than 50 years
- Dissatisfaction with the outcome of the procedure
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https://www.uptodate.com/contents/total-knee-replacement-beyond-the-basics?search=knee%20replacement&source=search_result&selectedTitle=2~125&usage_type=default&display_rank=2
https://emedicine.medscape.com/article/1250275-overview
https://bonesmart.org/knee/recovery-total-knee-replacement-surgery/
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2818%2932531-5/fulltext
https://www.farnorthsurgery.com/blog/difference-between-major-and-minor-surgery