• Rukmani Birla Hospital,Gopalpura Bypass Road, Near Triveni Bridge,Gopalpura,Jaipur – 302018.

What is Total Knee Replacement or Arthroplasty?

Total knee arthroplasty or popularly known as the knee replacement surgery is a surgical procedure to relieve pain and restore normal function in the severely ailing knee joint. The surgery resurfaces a knee damaged by injury or arthritis. It involves separating the damaged bone and cartilage from the thighbone, shinbone, and knee cap and substituting it with an artificial joint also called prosthesis. This artificial joint is made of high-quality metal and high-grade plastics.

This surgery is recommended for patients who face extreme difficulty in taking any function from the knee joint such as climbing stairs, walking, sitting or lying. Foremost, non-surgical methods such as medications and mobility aids such as walkers, sticks, etc. are used; if even post such methods, the functioning is hard and these methods prove unsuccessful, the doctors might recommend a total knee arthroplasty in such cases. A total knee arthroplasty is an effective and safe procedure that enables the person to resume normal activity by correcting the leg deformity and relieving pain. With increasing advancement in technology and the medical field, today a total knee arthroplasty is considered one of the safest surgical procedures in all of medicine. 

To assess if a total knee arthroplasty is the best alternative for you, the orthopaedic surgeon will analyze the knee’s motion ability, stability, and strength and also conduct several tests including X-rays to determine the damage and assess the present condition. The doctor might also run some tests on the blood and urine, as well as do an electrocardiogram to plan the surgery. The choice of prostheses and surgical techniques will depend on the person’s age, weight, activity level, overall health, and the condition and shape of the knee.

Reason for total knee arthroplasty

The prime reason for a total knee arthroplasty is the severe pain because of osteoarthritis or injury. Both conditions might damage the knee joint, making simple movement and activities – such as walking, sitting, lying down, climbing stairs, getting up and sitting back, etc. – difficult to do.

Types of arthritis affecting the knee joint

Osteoarthritis: A type of degenerative arthritis that causes a breakdown of joint cartilage and corresponding knee bone. This mostly occurs in middle-aged and older adults.

Rheumatoid Arthritis: This type of arthritis causes pain and stiffness in the knee joint because of excess synovial fluid which is caused due to inflammation of the synovial membrane.

Traumatic arthritis: A type of arthritis that occurs because of injury and causes heavy damage to the knee joint.

Risks involved in total knee arthroplasty

While a total knew arthroplasty or knee surgery is a very safe surgical procedure, yet like all normal surgeries, this too is susceptible to some risks such as:

  • Blood clotting in legs or lungs
  • Stroke
  • Heart attack
  • Infection
  • Nerve or blood vessel damage
  • Infection 
  • Implant problems
  • Continued pain

That said, the most common and likely to occur factor is an infection post a total knee arthroplasty. A person suffering from an infection after the surgery might display symptoms such as high fever, chills, shivering, swelling, leakage from the surgical area, tenderness, acute joint pain, and increasing redness. Apart from this, the artificial joint used to replace the original knee joint can also wear out causing the total knee arthroplasty to completely fail. This happens over time when the artificial joint wears away due to excessive and stressful physical activity, weight lifting, etc.

That said, some of the essentials that one must know and take note of before deciding on the total knee arthroplasty are:

Food and medications: To prepare for the surgery, the doctor might suggest you avoid certain medications or supplements. Also, the doctor may ask you to not eat anything post-midnight on the day of the surgery.

Post-surgery preparations: Post the total knee arthroplasty, one might need to use crutches or a walker or even take some rest. Make sure to make all arrangements before in hand to ensure a smooth recovery process. Make arrangements such that you avoid taking the stairs, have safety bars and handrail for support in the washroom, keep your leg elevated while sitting, sit while taking a shower and take a higher toilet seat.

The recovery from a total knee arthroplasty is slow but effective. In most cases, it relieves pain, improves mobility while enhancing the quality of life. A knee replacement can last for as long as 15 years if proper care is taken. A person can resume everyday activities almost after three to six weeks post the total knee replacement surgery. More strenuous activities such as swimming, golfing, biking, can be engaged post full recovery, although for activities such as jogging, jumping, skiing, tennis, sports, you must consult your doctor before undertaking any activity which might involve stress on the replaced knee.

During the recovery period and post the recovery, the doctor might advise you undergo some physical therapy to strengthen the replaced joints and maintain smooth movement of the replaced knee. Depending on case-to-case, special recommendations for diet, physical activity, the recovery process, follow-ups, may be made. Total knee arthroplasty is a collective decision and one that must be made will full consideration of the current condition, the need, as well as the after-effects. 

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