What is total knee replacement?

Total knee replacement is a surgical procedure to replace a damaged knee joint with a prosthesis (an artificial joint) made up of metal and plastic. Another common term for total knee replacement surgery is knee arthroplasty.

Who can benefit from total knee replacement surgery?

There are different types of arthritis (predominantly osteoarthritis) that can wear away the surfaces of the knee, causing pain, mobility difficulties and stiffness. In these instances, a total knee replacement may be necessary. Other medical conditions including bone defects and growth problems, as well as injury to the knee joint may also signify that total knee replacement surgery is required.

Procedure

Total knee replacement surgery is usually performed under a general anesthetic, and takes around two hours. An incision is made to expose the kneecap, which is then pushed aside so that your surgeon can access the damaged ends of the thigh and shin bone. The damaged bones are then removed, and a prosthesis is then modelled on the measurements of the removed bone. The ends of the thigh and shin bone are replaced using the new metal fittings, and set in place using bone cement (sometimes this is not necessary). A piece of plastic is then inserted between the two metal ends, acting as substitute cartilage, and helping to reduce any friction. The incision is then closed using stitches or surgical clips, and finally bandaged (sometimes with a splint). Sometimes a tube may be left in the knee to allow fluids to drain out, but will be taken out around 48 hours following surgery.

Recovery period

You will be required to stay in hospital for a few days (no longer than a week) following surgery, and will be assigned a physiotherapist to assist you in walking using a walker, followed by a cane or crutches. They will also give you a range of exercises to perform to help strengthen the joint. It may take up to three months to regain full mobility and for any pain and swelling to subside. Patients can usually return to work and start to drive around 4-6 weeks following total knee replacement surgery, however this can vary depending on the individual and the nature of their job.

Risks

Complications associated with total knee replacement surgery include wound infection, bleeding, fluid build-up, blood clotting and tissue damage. Fracture to the prosthesis, numbness, dislocation and a noticeable difference in leg length are also possible risks.