How is a Total Knee Replacement Done

Knee problems are common in today’s world due to unhealthy changes in your lifestyle. Nowadays, more individuals are diagnosed with knee problems such as arthritis and other degenerative knee conditions.  It leads to discomfort, and pain that limits your activities. Your doctor may suggest surgery such as total knee replacement when the knee condition affects your daily activities and lowers your quality of life. Let’s understand more about total knee replacement and how it is done.

What is a Total Knee Replacement?

Total knee replacement (TKR) or total knee arthroplasty (TKA) is a surgical procedure performed to relieve knee pain, improve mobility, and enhance your quality of life. TKR surgery replaces the damaged parts of your knee joint with  artificial implants or prostheses. The surgery aims to alleviate pain, improve joint function, and increase mobility.

The procedure is typically recommended for patients who have severe knee arthritis or knee injury and has not responded to other treatments. It is most commonly performed on older adults but can also be done on younger patients in case of trauma or injuries.

Anatomy of the Knee Joint:

Your knee joint is a complex structure consisting of the following components:

1. Bones: Three bones meet to form your knee joint – Femur (your thigh bone), Tibia (your shinbone), and Patella (your kneecap).
2. Cartilage: The ends of the shinbone and thigh bone are covered by a tissue known as cartilage. It creates a gliding surface for the bones.
3. Ligaments: Tissue that connects bone to another bone.
4. Tendons: Tissue that connects muscle to bone.
5. Muscles: These muscles are present in the front and back of your thigh- Quadriceps and Hamstrings.

When is a Total Knee Replacement Recommended?

TKR surgery is indicated when chronic (long-lasting) knee pain with reduced mobility and stiffness is limiting your daily activities like standing, walking, running, getting up from a chair, climbing the stairs, etc., due to the following conditions:

• Long standing osteoarthritis (most common)
•  rheumatoid arthritis
• Knee trauma and injury causing loss of movement of the joint and inflammation
• Hemophilia
• Gout
• Due to the wear and tear of the knee cartilage
• Death of bone in the knee joint following decreased blood supply

How is a Total Knee Replacement Surgery done?

If your doctor has recommended a TKR surgery, then the next steps will be to get an initial evaluation done and plan for the surgery.

Initial Evaluation

• Complete Health Checkup: This includes blood tests, urine tests, chest X-rays, ECG (electrocardiogram – which measures the electrical activity of your heart), Ultrasound or MRI of the knee (Magnetic resonance imaging). Your doctor may also request further tests if required.
• Consulting your Surgeon: Your surgeon will analyze the results of your medical tests and ask you to visit the concerned specialists if you have any further medical concerns, such as diabetes or heart problems.

Before the surgery

• Your surgeon will explain the procedure and clear all your doubts.
• You will be asked to sign a consent form for your permission to perform the surgery.
• After noting the medical history, a complete physical examination is conducted.
• Any drug or anesthesia-related allergies have to be informed before the procedure.
• Pregnancy or any doubt of being pregnant has to be notified to the surgeon.
• You will be instructed to fast before the procedure depending on the type of anesthesia you will be recieving. 

During The Surgery

• An intravenous (IV) line may be started in your arm or hand and a urinary catheter may be inserted.
• Your heart rate, blood pressure (BP), breathing, and blood oxygen level (SpO2) will be continuously monitored during the surgery.
• The surgical site will be cleaned with an antiseptic solution.
• The surgeon will make an incision (cut) to gain access to the patella (kneecap). In the traditional technique, an 8-10 inches incision is made, and in the minimally invasive technique, it is 4-5 inches long.
• Once your knee is open, the surgeon rotates the patella (knee cap) outside the knee area. This gives access to view the surgical area.
• The femur (thighbone) is the first bone that is resurfaced. Once the knee joint is exposed, special instruments are used to make precise cuts after measuring the bone.
• The damaged bone and cartilage from the end of the femur are cut away. The end of the femur is cut away to place the first artificial component, the femoral component, using bone cement to seal it in place.
• The surgeon next resurfaces the shin bone (tibia). The damaged part is removed and the metal and plastic tibial component is fixed.
• The bottom portion of the implant (tibial tray), is fitted to the tibia and secured into place using bone cement.
• Later, a metal-grade plastic is placed in between, which acts as a buffer. This provides support when you blend and flex your knee.
• Then, the patella is placed into its normal position.
• Your surgeon will bend and flex the knee to ensure the implant is working correctly.
• The incision is then closed with stitches or staples and then bandaged. 

After the Surgery

You will be taken to a recovery room, and your vitals will be monitored until you are stable. (pulse rate, blood pressure, body temperature, respiratory rate). Your physical therapy sessions will start the next day of your surgery, and you may be hospitalized for another 2 to 3 days, depending on your recovery rate. . It may take up to 12 months for you to fully recover and get back to your normal activities. However, most patients may resume their daily activities and return to work within 6 months following the surgery.

Takeaway

Total knee replacement has become a common procedure in various parts of the world. A 2019 study found that 82% of complete knee replacements remain functioning even after 25 years of placement. The majority of people’s physical activity levels have improved as a result of this procedure. Our skilled orthopedic surgeons at Medfin perform the latest surgical techniques and can guide you on all aspects of the procedure.

Disclaimer: The content on this site is the copyright of Medfin and is intended for informational and educational purposes only. This should not be considered as a substitute for medical and surgical expertise. Results from any treatments or surgeries are subjective to an individual patient and the type of procedure/surgery performed. Please seek professional help regarding any medical concerns. Medfin will not be responsible for any act or omission arising from the interpretation of the content present on this page.