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Total Knee Replacement Surgery
Total knee replacement and the related resurfacing (partial) replacement surgery are procedures in which the orthopedic surgeon removes damaged bone and cartilage from the knee joint and implants an artificial joint surface that is designed to mimic the rolling, gliding motion of the human knee. The prosthesis is customized to the patient's joint, taking into consideration the patient's age, weight, general health and activity level. Knee replacement, followed by rehabilitative therapy, alleviates pain and restores function in the damaged knee joint.
As cartilage wears away over time and bone becomes exposed, bone surfaces rubbing against each other cause pain, resulting in a diagnosis of arthritis. A person with advanced arthritis of the knee joint resulting in severe pain that interferes with daily activity is typically a candidate for total knee replacement or a related form of resurfacing.
What Is Knee Replacement Surgery?
In knee replacement surgery, the surgeon removes the damaged surfaces of the bones and then fits replacement components into place. The prosthetic knee implanted in a total knee replacement consists of three pieces made of rugged polyethylene (high density plastic) and alloy metals. These pieces resurface the three bones that comprise the knee joint. The surface of the femur is replaced with a rounded metal component that comes very close to matching the curve of the natural bone. The surface of the tibia is replaced with a flat metal component that holds a smooth plastic piece made of polyethylene that serves as the cartilage. The undersurface of the patella may also be replaced with an implant made of polyethylene. The knee replacement appears and functions much like a normal knee. After knee replacement surgery, the patient will recover most of the normal range of motion of the knee, from extension (straight leg) to flexion (bent leg).
Why Is Knee Replacement Surgery Needed?
Knee replacement surgery is necessary when the joint is worn or damaged so severely that mobility is reduced and there's pain even while resting.
The most common reason for knee replacement surgery is osteoarthritis.
Other health conditions that cause knee damage include:
- Knee deformity with pain or loss of cartilage
- Knee injury
- Rheumatoid arthritis
- Unusual bone growth
What Are the Risks of Knee Replacement Surgery?
As with any surgical procedure, there's always the risk of complications. Our surgeons will discuss all potential risks before surgery.
The most common risks include:
- Allergic reactions
- Blood clots in the veins of the leg
- Nerve damage
How Can You Prepare for Your Knee Replacement Surgery?
After knee replacement surgery, getting around may be difficult. It's essential to make preparations to ensure a smooth recover.
Here are some suggestions to help you prepare:
- Arrange a one-level living space
- Clear a walking path around furniture
- Place items within reach
- Move tripping hazards
- Strengthen and exercise your knee(s)
Most importantly, ask for help. The recovery process can be difficult so having support from family and friends is essential.
Additionally, as part of the Lifespan Orthopedic Institutes’ preparation process, each patient participates in an hour and a half education session with nurses and therapists before their surgery. The session provides an overview of the entire recovery and rehabilitation process.
Damian Dupuy, MD, former director of tumor ablation at Rhode Island Hospital, discusses his total knee replacement surgery performed at The Miriam Hospital’s Total Joint Center.
What Can You Expect?
Knee replacement is one of the most commonly performed procedures in orthopedics. At the Lifespan Orthopedics Institute, we have refined our surgical process to provide patients with the latest advances in treatment options.
Changes in surgical techniques, post-surgical protocols, and anesthesia and nerve blocks have led to numerous improvements for patients, some of which include becoming mobile sooner after surgery, having a speedier recovery, and a shorter hospital stay.
In most cases, patients are prepared to be discharged the day of surgery or within 24 hours.
Patients who are candidates for rapid discharge will:
- Have at-home physical therapy
- Receive home nursing evaluation and services
- Recover in their own home
After the Knee Replacement Surgery?
The first 12 weeks following a total knee replacement are crucial to return to an active lifestyle. Having a recovery plan and committing to it as much as possible will help you heal faster and improve the chances of long-term success.
How Much Recovery Time Will I Need After Surgery?
In most cases, patients are encouraged to begin ambulation the same day as their knee replacement surgery. Typically, one or two days of recovery in the hospital is standard, although patients can stay longer if needed while others may be able to return home the same day. Additionally, for some patients, a rehabilitation center may be the best option post-surgery.