Educate: Total Knee Replacement
Sometimes called a Total Knee Arthroplasty, this surgical option is for patients who have been found by their surgical team to have damage to one or more areas of the knee. This section will provide clarity on what to expect before, during, and after the procedure. Understanding these can help patients make informed choices about their treatment options.
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Understanding Total Knee Replacement
The knee can be divided into three sections: the medial (inside), the lateral (outside), and patellofemoral (knee cap). A total knee replacement replaces all three of these compartments, while a partial knee replacement only addresses one compartment. Because a total knee replacement fixes the whole knee, it is a bigger surgery, with more pain, and longer recovery time when compared to a partial knee replacement.
How do you do a Total Knee Replacement?
The surgical team will remove arthritic bone and leftover degenerated cartilage along the surfaces of your bone, only 7-10 mm or so around each surface of the femur (thigh bone) and tibia (shin bone). Personalized sizing is then determined and any bone deformities corrected.
The surgery can be done with or without computer-navigation. Computer-navigation is used to customize the cuts specific to each patient’s anatomy. Titanium components are then fixed to your bone with bone cement and a plastic liner is placed in-between. This plastic liner is your “new cartilage”. This provides a friction free, painless surface for you to walk and move your knee around.
What's the Recovery Time?
After surgery, you will be using a walker for about the first week or two after surgery. When ready, you will transition to using a cane for about 1-3 weeks. By 4-5 weeks after surgery, many patients might not need to use any external supports. “Recovery” is different for every patient, and even different from one knee to the next. No two patients are the same, and no two joints are the same. As a rule of thumb, it can take approximately 3 months to return to 80% “recovered” and you can continue to improve up to about 1 year after surgery. Just keep in mind that everyone heals and recovers at a different pace.
How Long does a Total Knee Replacement Last?
Modern knee replacements are designed to last for many years, often 15 to 20 years or more. This durability can provide long-term relief and functionality.
What are the Potential Surgical Complications?
Total knee replacement surgery is primarily designed to relieve pain; however, it may not eliminate all discomfort, and patients might still experience residual stiffness and swelling. Although complications are relatively uncommon, occurring in about 1-2% of patients, there remains a risk of serious postoperative issues. These complications can include life-threatening conditions such as heart attacks, strokes, pulmonary embolisms, and kidney failure. Additionally, stiffness or loss of motion can occur following the procedure.
Infection, which affects around 1% of patients, is one of the most debilitating complications and often necessitates prolonged antibiotic treatment and multiple additional surgeries to resolve. Another common complication is the development of blood clots in the leg, which typically requires the use of blood thinners after surgery to minimize the risk. Furthermore, the implants used in the procedure can fail over time due to wear or loosening of the components, although this generally happens many years after the surgery. For a total knee replacement 90 to 95% last more than 10 years.
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More Information
To watch a video of a knee replacement, click here. Warning! This is an actual total knee replacement filmed in an operating room, and contains graphic images of skin, blood and bone. If you prefer information in written form, click here.
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