Total Knee Replacement

Total Knee Replacement Surgery

Total Knee Replacement is a surgical procedure in which surgeons will replace the damaged Knee part with artificial parts. We call this procedure as Arthroplasty. Arthroplasty means to shape. Artificial Knee parts are known as Prosthesis.

Total Knee Replacement is also known as Total Knee Arthroplasty. Total Knee Replacement is a procedure to remove the damaged portions of the knee and to cap the bony surfaces with man-made prosthetic implants. A total knee replacement repositions the knee into proper alignment and replicates the original function.

Index:

Total Knee Replacement Overview:

 

Total Knee Replacement Overview

Total Knee Replacement is the medical procedure in which an Orthopedic Surgeon will replace both sides of the knee joint with artificial implants. When a knee or both sides of knee joints gets damaged because of Osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis, knee joints have to be replaced.

When an individual gets affected with any of the above-mentioned conditions, then gradually their knee decreases its function. And this leads to Total Knee Replacement.

In this post, we will illustrate types of knee replacements, risks involved, recovery time after total knee replacement, etc.

Types of Knee Replacements:

In Knee, there are three compartments, the medial compartment, the Lateral compartment, and the patellofemoral compartment. If any of the compartments get affected, then Knee Replacement takes place. Typically, there are two types of Knee Replacements.

  • Partial Knee Replacement
  • Total Knee Replacement

Partial Knee Replacement:

As the name itself suggests that only affected knee part is replaced with artificial implants. Partial Knee Replacement can be done to Inside Part, Outside Part or Kneecap Part of the Knee. 

Total Knee Replacement:

In Total Knee Replacement, they replace complete Knee comprising three compartments with artificial implant materials.

Symptoms for Total Knee Replacement:

Symptoms of Total Knee Replacement

 

Doctors prefer the Total Knee Replacement for many reasons. Some of them are, when a person cannot climb the stairs, cannot able to sit or even lying down. However, surgeons first prefer to choose options other than Knee Replacement. We mention the symptoms below.

  • Severe pain, stiffness, chronic inflammation or degeneration that limits everyday activities.
  • Pain that interferes with sleep
  • Mild Knee Deformity

Reasons for Total Knee Replacement:

 

Reasons For Total Knee Replacement

Common reasons for undergoing Total Knee Replacement includes:

  • Osteoarthritis:

Osteoarthritis occurs in the people with age above 50 years. This caused because of the main wear and tear of the knee joint.

  • Rheumatoid Arthritis:

We also know Rheumatoid Arthritis as Inflammatory Arthritis. When the membrane around the knee joint become thick and inflamed, it causes Rheumatoid Arthritis.

  • Post-Traumatic Arthritis:

Post-Traumatic Arthritis causes when there is a severe injury around the knee joint like ligament tear or knee break.

Total Knee Replacement Alternatives:

Total Knee Replacement Alternatives

When a person is feeling Knee Pain, then he/ she must visit the Orthopedic Doctor. Orthopedic Doctor will check the condition of the knee, up to what extent the knee got damaged and they will suggest what to do. If the knee pain is in the starting stage, then Orthopedic doctor immediately won’t opt for Knee Replacement. Instead of replacement, the orthopedic doctor will suggest other alternative ways to control knee pain. Check with the alternative methods which give you pain relief. Here is the list of some alternative methods:

  • Weight Loss and Exercise
  • Knee Injections
  • Physiotherapy
  • Medication
  • Acupuncture
  • Kneecap Replacement
  • Mini-Incision Surgery
  • Image-Guided Surgery
  • Arthroscopic washout and debridement
  • Autologous chondrocyte implantation (ACI)
  • Prolotherapy
  • Arthroscopic Surgery
  • Stem Cells Treatment
  • Plasma-Protein Injections
  • Knee Osteotomy

Risks Involved in Total Knee Replacement:

Risks involved in Total Knee Replacement

Total Knee Replacement involves fewer risks. The following are the possible risks.

  • Infection, which affects less than 2 percent of patients
  • A blood clot in the legs
  • A blood clot in the lungs, or pulmonary embolism
  • A fracture during or after surgery
  • Nerve damage, leading to numbness or weakness
  • Continued pain or stiffness
  • Anesthesia Problems
  • Cardiac Risks

Managing Risks in Total Knee Replacement:

Managing Risks in Total Knee Replacement

Total Knee Replacement follows many complications which are treatable. Prevention is the best medicine for managing risks involved in Knee Transplantation.

Orthopedic doctors will use Antibiotics before, during and after the surgery which will reduce the occurrence of infection.

Blood clots are one of the risk factor involved in Knee Replacement. So, your physician will take preventive measure and will make you practice various exercises to avoid clotting.

Above all, sometimes, surgical risks are also occurs after knee replacement. However, if the surgical technique is good, one can avoid those risks.

Implant Materials in Total Knee Replacement:

Implant Materials in total Knee Replacement

Three major components that comprise the knee joint

  • The Femur (Thigh Bone)
  • Tibia
  • Patella

A wide range of knee replacement implant designs exists. Metals including Titanium, chrome/cobalt alloys, Zirconium alloys, etc are used to make these designs. They also use synthetic materials such as dense Polyethylene plastics and zirconium-based ceramic composites.

The Femoral Component is most often a curved metal cap that emulates the shape of femoral condyles. And it has a groove in the center that allows for patellar movement. If the Patellar needs to resurfaced, then the rear articular surface will be removed. And it will replace this with Polyethylene.

Tibial components may differ. Some comprise metal cap fixed to the tibial surface with the stand that inserts into the core of Tibia. The stand may either cemented in the bone or designed by Porous surface. This allows checking a bone ingrowth aligned in a place.

A synthetic bearing that articulates with Femoral Prosthesis positioned on the top of the metal surface. Or those some designs don’t have a metal plate and instead fixed directly to the Tibia.

The Tibial Bearing may be a Fixed or Movable Bearing. Fixed Bearing implants are secure to the Tibial Platforms. Whereas movable bearing implants move on the base allowing from the limited amount of joint rotation.

Your surgeon will help you choose the vast available design for your knee condition. Some of them are Age, weight, gender and activity level based on their experience with particular designs and surgical techniques.

Tests Required for Total Knee Replacement:

Tests Required for Total Knee Replacement

Before undergoing surgery, a pre-surgery checkup is mandatory to know the health condition of the patient. They will conduct blood Tests, Urine tests, X-rays, to know the internal health of the patient.

A dental checkup is important to examine any infections in the gums or teeth. If any found, then treatment will be started to reduce the infection.

Pre-Operative Procedure for Total Knee Replacement:

Pre-Operative procedure for Total Knee Replacement

Before surgery, they will do the pre-operative procedure. In this process, your joints next to the damaged knee will be observed carefully. So, the surgeons will know which part of the knee to be replaced. By doing this, the result after the surgery will be great.

They will do general Blood Tests to know any heart, lungs related diseases are there.

Before the procedure, Orthopedic surgeon will verify the X-Ray to know how much the extent of Knee damaged and to find any shape irregularities.

Total Knee Replacement:

Total Knee Replacement

First, they will position you on your back for the procedure and may undergo general Anesthesia. General anesthesia is a combination of medications which put the patient to unconsciousness. Apart from general anesthesia, there are other anesthesia’s which are Regional Anesthesia and Femoral nerve Block.

In Regional Anesthesia, a small tube called an Epidural Catheter delivers medication to the Spinal Column. This will numb you from the waist to down. Or Femoral Nerve Block that numbs the surgical region. Now your knee will be free to place in a bend position to enable access to the joint surfaces.

Step 1:

Surgical details vary by procedure and component design. Some procedures involve computer-assisted 3D Emerging and Micro Robotic Instruments to aiding and removing damage parts of the Joint. While other procedure uses manual instruments with procedure guides.

Step 2:

They will make an incision on the midline of the front of your Knee. Minimally Invasive Procedures use 4 to 6-inch incision. Whereas Open Procedures traditionally require 7 to 10-inch incision.

Step 3:

The Surgeon accesses the joint. He moves Patella to the side to provide access to Femur and Tibia. They remove any bony outgrowths along the margins.

They do not spare the Anterior Cruciate Ligament and the Posterior Cruciate Ligament in procedures by the PCL’s.

Step 4:

Cutting planks or guides are fixed to Femoral Condyles. Retracts how tissue is away from the joint and protect the collateral ligaments and patella tendon when bones are cut.

Step 5:

Using the guides, the surgeon makes a precise cut to remove the generative portions of the Femur. Later they sculpt the end to accept the Femoral Prosthesis.

Step 6:

A Tibial Guide is placed to remove the small portion of the Tibial Surface. If the Patella needs resurfacing, a series of similar steps are used to remove the damaged portion. Then we have to prepare for the implant.

Step 7:

Next, the permanent Femoral Patellar Antibia Prosthesis is positioned and secured in place. And removes excess cement.

Step 8:

The Bearing surface is fixed to the Tibial Plate to complete the repair.

Step 9:

Finally, the various layers of tissues are closed with dissolvable stitches. And the skin incision is closed with the stitches or surgical staples.

Step 10:

A bandage is wrapped around your knee and they will take you to recovery.

Fast Track Total Knee Replacement:

Fast Track Knee Replacement

Accurate alignment can enhance the overall function of the new joint, helping it to feel healthy again and potentially last longer.

It’s true that computers have enhanced the way we live. Computers made our lives easier and more efficient whether that is in the home or in the work. We now find these technological advancements in Operating rooms.

Surgeons now having the leading edge computers at their command. Using them as a vital tool to live at a high level of treatment.  

For instance, recent advances in Computer-assisted technology had made possible for the Orthopedic doctors to navigate joints with a new level of accuracy. And giving the patient a more customized fit.

Computer Navigation Technique Procedure:

 First, the surgeon moves the instrument within your joint, special infrared trackers calculate its position. And wireless instruments instantaneously transfer the data to a computer in the Operation Room.

It then displays this information on the monitor. As the interactive model of the anatomy or blueprint that supply with various angles, lined and measurements of your unique anatomy.

Computer-assisted surgery allows the surgeon to plant with a partial three-dimensional model of your hip or knee.

Accurate alignment of hip or knee components is critical to the overall function of your new joint. And it also plays a role in helping your joint feel healthy again and helping the joint to last longer potentially.

Advantages of Computer Navigation Technique:

  • For the patients, there are several potential benefits of computer-assisted surgery. Precise placement may increase the life of the implant. 
  • Computer-assisted surgeries such as Stryker Navigation Technology may also allow lots and ways of surgical techniques.
  • This has several potential advantages such as reduced blood loss, less need for transfusion, faster recovery, less hospital stay, shorter post-surgery rehab, and less scarring.

Disadvantages of Computer Navigation Technique:

There is a risk of dislocation and later revision surgery. Greater joint stability and range of motion. The improved overall function of joint replacement.

 

Care after Total Knee Replacement:

Care After Total Knee Replacement

They give the patient with Total Knee Replacement compression stockings to wear to reduce the possibility of clots after the surgery. Pain and discoloration following the procedure are common and will subside in time.

Recovery Time After Total Knee Replacement:

Recovery Time After Total Knee Replacement

Most patients will be ready to return home in three defined days. And we advise you to begin Physical Therapy as soon as possible. Non-observable stitches or staples will be removed in 2 weeks.

For complete recovery of your knee as before the surgery will occur in between 3 and 6 months.

FAQ’S:

FAQ's

1. How much time will it take for Total Knee Replacement Surgery?

Total Knee Replacement procedure takes one to three hours to complete.

2. What is the average age for Total Knee Replacement?

Most of the people undergo Total Knee Replacement at the age of above 50 and 80. But the average age for Knee Replacement is around 70

3. Success Rate for Total Knee Replacement

Knee Replacement is one of the most successful surgical procedure performed in India. Around 98% to 100% of the people are leading a better quality life after knee replacement.

4. How much time will it take to recover from Knee Replacement Surgery?

After knee replacement surgery, it will take 12-24 hours to make you stand. But it varies from an individual. After knee replacement surgery, it will take 3 to 5 days to discharge from the hospital depending on the patient’s recovery. It will take around 12 weeks to start your normal routine. For the first three months, do small household chores. Avoid standing for a long time.

5. Is Knee Replacement Painful?

After knee replacement is performed and rehabilitation is done, 90% of the people won’t have any complications or pain. But we cannot say that it is true. Because 10% of people might suffer from pain because of infections and many other reasons.

Knee Replacement people can walk slowly after 6 weeks from surgery. However, it will take up to 3 months to decrease pain and swelling.

6. What are the exercises to be done after Knee Replacement Surgery?

 

Straight Leg Raises

 

 

Knee Straightening Exercises

 

After Knee Replacement Surgery, your Orthopaedic doctor will guide you in slowly starting exercises. Here are exercises for postoperative knee replacement.

  • Quadriceps Sets
  • Straight Leg Raises
  • Ankle Pumps
  • Knee Straightening Exercises
  • Bed-Supported Knee Bends
  • Sitting Supported Knee Bends
  • Sitting Unsupported Knee Bends

7. How Long will the Artificial Knee Joint last?

A study shows, above 85% of people who underwent artificial knee replacement can handle artificial knee joint for 15 to 20 years.

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