Astha Orthopaedic Hospital

Knee Replacement

1. What is Total Knee Replacement (TKR)?

Total knee replacement (TKR), also referred to as total knee arthroplasty (TKA), is a surgical procedure where worn, diseased, or damaged surfaces of a knee joint are removed and replaced with artificial surfaces. Materials used for resurfacing of the joint are not only strong and durable but also optimal for joint function as they produce as little friction as possible.

2. How it is done?
A knee replacement usually takes up to two hours. Your surgeon will make a single cut (10 to 30cm long) down the front of your knee. Your kneecap is moved to one side to reach the knee joint. The worn or damaged surfaces are removed from both the end of your thigh bone and the top of your shin bone. The surfaces are shaped to fit the artificial knee joint. The new joint is fitted over both bones. Sometimes the back of your kneecap is replaced with a plastic part. This is called patellar resurfacing. After the new joint is fitted, the skin cut is closed with stitches or clips and covered with a dressing. Your knee will be tightly bandaged to help minimize swelling.

3. Why is it done?
The most common reason for knee replacement surgery is to repair joint damage caused by osteoarthritis and rheumatoid arthritis.

4. Possible Risk and complication?

Specific complications of knee replacement are uncommon, but can include those listed below:

Infection of the wound or joint. Antibiotics are given during and after surgery to help prevent this.

Unstable joint. The knee joint may become loose and you may require further surgery to correct this.

Damage to nerves or blood vessels - This is usually mild and temporary.

Scar tissue. This can build up and restrict your movement - Further surgery may be needed to correct this.

The artificial knee joint usually lasts for 10 to 15 years, after which you may need to have it replaced. The exact risks are specific to you and will differ for every person, so we have not included statistics here. Ask your surgeon to explain how these risks apply to you.

5. Is TKR for you?
Most patients who undergo total knee replacement are age 60 to 80, but orthopaedic surgeons evaluate patients individually. A people may consider TKR if there is:

Daily pain

The pain is severe enough to restrict work, recreation and ordinary activities of daily living

Significant stiffness in the knee

Significant instability (constant giving way) of the knee

Significant deformity (knock-knees or bow-legs) that hinders normal function of the knee

Damage from arthritic conditions, such as osteoarthritis, rheumatoid arthritis or post-traumatic arthritis

6. What are the alternatives?
Surgery is usually recommended only if non-surgical treatments, such as physiotherapy and exercise, taking medicines or using physical aids like a walking stick, no longer help to reduce pain or improve mobility. Alternative surgical procedures include osteotomy (where the leg bones are reshaped). Your surgeon will explain your options to you.

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