Total Knee Replacement Surgery is a common operation to treat advanced arthritis. An orthopedic surgeon replaces the damaged/worn part of the knee joint with an artificial knee made of metal and plastic to reduce pain and improve function.
Most people find total knee replacements really beneficial, reporting a marked decrease in pain and improvement in their day to day life.
Here we will look at how you prepare yourself for surgery, what the operation involves, and what happens afterwards.
Before having total knee replacement surgery, you will have a pre-op appointment a few days/weeks before your operation where the surgeon will review your x-rays and talk you through what is going to happen. This is a good opportunity to ask any questions you may have.
At the same appointment you will also see a physical therapist who will talk through knee replacement rehab and recovery eg exercises for you to do after the operation. It is well worth doing these exercises before the surgery as the stronger and more flexible your knee is before surgery, the quicker you will recover. Visit the knee replacement exercise section for suitable exercises.
On the day of your operation you be admitted to hospital and then have your total knee surgery.
Total Knee Replacement Surgery is usually carried out either under a general anaesthetic or a spinal anaesthetic.
General Anaesthetic: you are put to sleep for the duration of the operation.
Spinal Anaesthetic: (epidural) numbs the body below the waist and you are also given medicine to make you sleepy.
A vertical incision (cut) is made on the front of the knee, usually about 8-10 inches long. The kneecap is moved to the side to expose the knee joint. The surgeon removes the damaged bone and cartilage. The Anterior Cruciate Ligament (ACL) is removed and often the Posterior Cruciate Ligament (PCL) is too. The Collateral Ligaments are preserved.
The bones are shaped to fit the new knee implant (prosthesis) which is then attached to the bone and held in place with cement. The wound is then sewn up with stitches. A dressing will be placed over the wound and the knee will then be bandaged to help reduce swelling.
Total Knee Surgery takes about 2 hours.
After your total knee replacement surgery, you will return to your ward and the nurses will ensure you are getting adequate pain relief.
Either later that day or the next morning, a physiotherapist will come to see you and help you get out of bed. You will most likely be able to fully weight bear on your new knee (ie put as much weight through your leg as you want) within 24 hours but you may need to use a frame, crutches or sticks for the first few days.
You will start your exercises straight away and will progress through the rehab programme as instructed by a physical therapist. Visit the knee replacement exercise section for suitable exercises.
People are normally discharged from hospital after 3-5 days (occasionally longer) depending on how they are doing. Before you can go home, you will need to be able to:
1) Get in and out of bed by yourself
2) Walk safely with or without crutches/sticks/frame
3) Climb steps and stairs (unless you don’t have any at home)
4) Fully straighten your knee
5) Bend your knee well, preferably at least 90°
About a month after total knee replacement surgery you will notice a dramatic improvement in your knee. However, it is normal for the knee to be swollen and uncomfortable the first few days following surgery but the pain settles down within a few weeks. You can help reduce the swelling by using Ice and Tubigrip (a special compression bandage).
It is really important to be doing exercises to build up the strength and flexibility around your knee to gain the full benefit of Total Knee Replacement surgery (see the knee replacement exercise section). You will be able to stop using any walking aids such as crutches or sticks as soon as you feel able – usually in a few days, and certainly by 6 weeks.
If you want to know more about knee replacement surgery, visit the sections below:
TKR Overview: Including how to tell if you would benefit from surgery
Rehab: Including what you can do to get the best results
Recovery: Including a guide to when you can return to activities
Common Problems: A guide to the most common problems associated with knee replacement surgery
Common Questions: Answers to the most frequently asked questions after knee replacements
Partial Knee Replacements: Less invasive surgery where only one side of the knee is replaced
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