Total knee arthroplasty is also more commonly known as total knee surgery. This surgery is performed to relieve the patient of the pain and restore the normal functionality of the knee joints. Total knee arthroplasty involves separating the damaged bone and cartilage from the thighbone, shinbone and kneecap and replacing it with an imitation joint, made of top-quality metal and plastic, also known as prosthesis. Through this, the surgery aims to enhance the functionality and relieve the pain of the critically ailing knee joint.
Total knee arthroplasty is suggested in cases where the knee joint has been damaged due to injury, trauma, ageing, weakening of bones or arthritis. Damaged knee joint causes acute pain and makes it extremely difficult to make any movements such as climbing stairs, walking, sitting or lying. However, total knee arthroplasty is suggested to a patient only when other forms of treatment such as medications and physical therapy fail to provide any relief. Moreover, efforts are made to restore mobility and functionality through the usage of walkers, sticks, etc.
A knew replacement surgery is a safe, effective and non-complicated procedure that helps a person to gain the functionality of the problematic knew joint and resume normal activity by correcting the leg deformity and relieving pain. Moreover, with developments in medical technology and procedures, knee replacement surgery is performed with precision and hence, it is one of the safest surgical procedures today.
That said, critical evaluation of the need for a total knee arthroplasty must be done before making the final decision. All alternative courses of treatment – including medications, therapy, non-invasive medical aids – should be tapped while analysing the need for a knee replacement surgery. An evaluation of the knee’s motion ability, stability, strength, flexibility, structure, etc. will be conducted by the orthopaedic surgeon. Before planning the surgery, the surgeon may also conduct some tests to gain deeper insights such as X-rays to assess the damage and present condition; blood and urine test; and an electrocardiogram to check for any heart disorders. Moreover, the selection of prostheses and surgical method will be made as per the patient’s age, weight, physical activeness, general health and most importantly the present and the expected future form and shape of the knee.
Surgical Procedure of a Total Knee Arthroplasty
The surgical procedure depends on the condition of the patient and the approach of the doctor. A general total knee arthroplasty takes 2 hours per knee. Overall, the common procedure includes the following steps:
- Checking of vital health signs before the surgery such as blood pressure, heart rate, body temperature, etc.
- Administering of anaesthesia or spinal nerve block depending per case
- The surgeon makes an 8-10 inch long incision down the centre of the knee while bending the knee at 90 degrees. The surgeon then makes a deeper cut to reach the tendons and flip over the kneecap to gain access to the femur and tibia.
- Then bone saw is used to remove the damaged parts and shape the remaining bones to accommodate the new prosthesis perfectly. The prosthesis is made of metal and plastic.
- The incision is closed with stitches and surgical staples. The surgeon may place a drain to remove the fluid.
- Post this, the wound is sterilised, bandaged and dressed.
Recovery after a Total Knee Arthroplasty
Total knee arthroplasty is a major surgical procedure and it will take some time for the new knee joint to recover and assume normal functionality. A knee replacement surgery is a boon for people suffering lack of mobility and functioning or excessive pain; the surgery enhances the quality of life and can even last for more than 15 years, provided care is taken. In general cases, a patient can resume normal routine activities almost after three to six weeks after the knee replacement surgery. However, it is advisable to refrain from rigorous activities such as swimming, golfing, biking, etc. which can be undertaken once complete recovery and a go-ahead from the doctor is acquired. Although activities such as jogging, jumping, skiing, tennis, sports, etc. can be resumed slowly. It is important to keep the doctor involved in the undertaking of any new physical activity that might stress the newly replaced knee joint.
Moreover, the patient may be advised to undergo some physical therapy, which is essential for the strengthening of the replaced joints and maintenance of the smooth movement of the replaced knee joint. Also, special diets, physical exercises, follow-up appointment and tests, might be suggested by the doctor to fasten the process of recovery.
Risks in a Total Knee Arthroplasty
Total knee arthroplasty is considered one of the safest surgical procedures in the medical world today and hence, is characterised with barely any risks apart from the general risks that are linked to any normal surgery. Some of the common risks involved in knee replacement surgery are:
- Blood clots in legs or lungs
- Heart failure or heart attack
- Damage of nerves or blood vessels
- Implant troubles
- Extensive pain even after surgery
Two other important risks that specifically pertain to a total knee arthroplasty are:
- A postoperative infection characterized by symptoms such as high fever, chills, swelling, seepage from the surgical site, tenderness, extreme joint pain, and redness.
- Wear out of the artificial joint put in place of the original knee joint. This can lead to a complete failure of knee replacement surgery. However, this is not experienced immediately after the surgery but instead occurs over time due to wear-tear of the knee joint because of excessive and rigorous physical activity, weight lifting, etc.
In all, total knee arthroplasty is a shared decision and one that must be made after careful analyses of the current condition of the knee, the need of the surgery, the intensity of symptoms and problems, as well as the after-effects of the surgery.