Overview of Procedure

A knee replacement is a surgical procedure involving the replacement of the faulty knee joint with a prosthetic. During a total knee replacement, the end of the femur bone is removed and replaced with a metal shell. The end of the lower leg bone (tibia) is also removed and replaced with a plastic piece with a metal stem. Depending on the condition of the kneecap portion of the knee joint, a plastic "button" may also be added under the kneecap surface.


The Right Candidates

Reasons that you may benefit from total knee replacement commonly include:

Severe knee pain that limits your everyday activities, including walking, climbing stairs, and getting in and out of chairs. You may find it hard to walk more than a few blocks without significant pain and you may need to use a cane or walker.

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: a bowing in or out of your knee

Knee stiffness: inability to bend and straighten your knee

Failure to obtain pain relief from non steroidal anti-inflammatory drugs. These medications, including aspirin and ibuprofen, often are most effective in the early stages of arthritis. Their effectiveness in controlling knee pain varies greatly from person to person. These drugs may become less effective for patients with severe arthritis.

Failure to substantially improve with other treatments such as cortisone injections, physical therapy, or other surgeries.


Risks and Side Effects

Your knee will feel sore and may be swollen for up to twelve months.

You will have a scar over the front of the knee.

You may not have any feeling in the skin around your scar. This can be permanent.


Surgery

Once you are under general anaesthesia (meaning you are temporarily put to sleep), spinal, or epidural (numb below the waist) anaesthesia, an eight- to twelve-inch cut is made in the front of the knee. The damaged part of the joint is removed from the surface of the bones, and the surfaces are then shaped to hold a metal or plastic artificial joint. The artificial joint is attached to the thigh bone, shin and knee cap either with cement or a special material. When fit together, the attached artificial parts form the joint, relying on the surrounding muscles and ligaments for support and function.


Recovery

Your orthopedic surgeon will start you on physical therapy on the day of the surgery or within the next few days after your surgery. Patients are encouraged to walk and exercise with the help of the physical therapist. In addition, the patient’s own high level of motivation and enthusiasm for recovery are very important elements in determining the ultimate outcome.

Results

Doctors recommend that patients should continue to stay active after surgery without overdoing it. You should notice a gradual improvement and a gradual increase in your endurance over the next 6 to 12 months. There will be guidelines that are generally applicable.