A severely damaged knee due to arthritis can be debilitating, making the simplest day to day activities challenging. The knee is a hinge joint formed by the lower-end of the thigh bone (femur), upper part of shin bone (tibia), and the kneecap (patella). Ligaments, tendons, and muscles help stabilize and move the joint. During arthritis the cushion surfaces wear away and bones begin to rub together, causing pain and limited motion in this weight-bearing joint. A total knee replacement is a surgical procedure where the knee joint is replaced with a prosthesis, or artificial implant. This surgery has been performed by orthopedic surgeons for over forty years and continues to be an effective option for patients suffering from knee pain due to a damaged knee joint.
Often times, your physician will discuss alternative treatment options for knee arthritis, as this is an invasive surgical procedure that has risks involved. In addition, your disease severity, symptoms, function, and overall health, play a role in determining the appropriate treatment options. Noninvasive possibilities include: activity modification, medications, and knee injections that can provide symptomatic relief. If the nonsurgical treatments are no longer helpful and your symptoms are inhibiting you from doing day to day activities, you may want to consider a total knee replacement.
During a total knee replacement, the surgeon will make a vertical incision approximately 8 inches long in the front of the knee. The damaged bone on the tibia, femur, and patella is removed and shaped to hold the implants. Next, the metal implants are cemented to the bone and the undersurface of the kneecap is replaced with a plastic button. A plastic insert is incorporated between the metal surfaces to allow a smooth surface during movement. The soft tissue around the knee and skin incision is closed with suture and/or staples. The procedure takes approximately 1 to 2 hours to perform. You will wake up from anesthesia in the recovery area and be transported to a patient room. Typically, patients will stay a few days in the hospital. Blood thinner medication is often prescribed to reduce the risk of blood clots after surgery. While recovering, you will learn skills and participate in physical therapy to get you walking safely.
Examples of surgery risks include:
- Blood Clots
- Reaction to anesthesia
- Blood vessel or nerve injury
- Kneecap dislocation
- Implant wear or loosening
Total knee replacement is a successful surgery to remove all or most knee pain due to arthritis. Some patients may continue to feel kneecap pain when kneeling after surgery. Most total knee replacements last 15-20 years. If the implant wears over time, you may need a revision surgery to remove the worn implant and replace it with a new prosthesis. It is important to discuss the risks of the surgery and expectations after the procedure with your doctor.