Total knee replacement

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Total knee replacement surgery is a surgical procedure for people whose knee joints are severely affected by osteoarthritis or another degenerative disease, or who have suffered a traumatic knee injury. If the damage to the knee is serious enough that repairing the joint isn't a viable option, then total knee replacement is an alternative that can vastly improve quality of life. Most people who have total knee replacement surgery have a dramatic improvement in their mobility and level of pain once they're fully recovered from the procedure.

Why Would Someone Need Total Knee Replacement Surgery?

If the bone and cartilage of the knee joint sustains severe damage, it's not always possible to repair the joint with surgery. This kind of severe damage can cause a considerable amount of pain and make it difficult to do everyday things like climb stairs, or walk. Some people even have pain when they're sitting down or lying down. The pain and reduced mobility can greatly reduce quality of life, but total knee replacement surgery can correct the problem to eliminate pain and restore knee function.

When someone has knee damage that can't be repaired, and experiences significant pain that can't be managed effectively with medication, then total knee replacement surgery can be a good solution.

However, if you're thinking of having this procedure it's important to realise that having the surgery doesn't always mean that the problem is solved forever. Even modern artificial joints have a limited lifespan of 15 to 20 years, so it's possible that some time in the future you may need revision surgery to replace the artificial joint.

About the Surgery

In the total knee replacement procedure, the patient's natural knee joint is replaced with an artificial joint. This is usually performed while the patient is under a general anaesthetic. Sometimes, however, a patient can't tolerate a general anaesthetic for medical reasons. In these cases they have a local anaesthetic combined with sedation to help them relax.

In a total knee replacement procedure, the surgeon first prepares the bones of the knee by removing damaged cartilage and bone from the ends of the leg bones—the tibia and femur—that connect to the knee joint. Next, they position the metal implants that will replace the cartilage and bone that was removed. The surgeon might also “resurface” the kneecap to improve the stability and flexibility of the joint. The final step is to place a spacer between the metal implants. This spacer is made of plastic and helps the joint move smoothly.

All surgical procedures have associated risks, and this procedure is no different. The risks of this surgery include excessive bleeding during surgery, and infection, deep vein thrombosis, pulmonary embolism during the recovery period. If you have a total knee replacement, following your surgeon's instructions for preoperative preparation and postoperative care will reduce your risk of complications.

Preparing for Surgery

Before a patient has the surgery, they'll have a preoperative evaluation to make sure their general health is good, and that they have no unresolved health problems that could potentially cause complications. The medications they take will also be reviewed, to make sure they're not using medications that might increase the risks of surgery.

Post-Op Recovery

After the procedure patients usually stay in hospital for several days. Most people find they can start to move their knee the same day, or the day after their surgery. They'll work with a physical therapist as they start to walk again, and may use a cane or other device to provide support and stability. Within 3 to 6 weeks, people usually find they can resume most of their normal daily activities.

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