Knee replacement surgery is one of the most common and successful procedures performed worldwide to relieve pain, improve mobility, and enhance the quality of life for individuals suffering from knee joint issues. Whether due to age, arthritis, or injury, knee pain can significantly affect your daily life. In this comprehensive guide, we will discuss what knee replacement is, when it is necessary, the types of knee replacement surgeries, and what to expect before, during, and after the procedure.

What is Knee Replacement Surgery?

Knee replacement, also known as arthroplasty, is a surgical procedure in which a damaged or worn-out knee joint is replaced with a prosthetic implant. The knee joint is made up of three main bones: the femur (thigh bone), tibia (shin bone), and patella (kneecap). Over time, these bones can become damaged due to various conditions like osteoarthritis, rheumatoid arthritis, or injuries. When the cartilage in the joint wears away, it can cause painful bone-on-bone friction, limiting mobility.

In knee replacement surgery, the damaged parts of the knee are removed and replaced with a metal and plastic prosthetic that mimics the natural movement of a healthy knee joint.

When is Knee Replacement Surgery Needed?

Knee replacement surgery is typically considered when conservative treatments such as medication, physical therapy, and lifestyle changes no longer relieve the symptoms of knee joint degeneration. The most common conditions that lead to the need for knee replacement include:

1. Osteoarthritis: This is the most common reason for knee replacement surgery. It involves the gradual wear and tear of cartilage in the knee, causing pain and stiffness.
2. Rheumatoid Arthritis: An autoimmune condition that causes inflammation in the joints, leading to pain and deformities.
3. Post-traumatic Arthritis: This condition occurs after a knee injury, such as a fracture, dislocation, or ligament tear.
4. Knee Deformities: Conditions like bow-leggedness or knock knees can place abnormal stress on the knee joint, causing degeneration over time.

If knee pain interferes with daily activities like walking, climbing stairs, or standing for long periods, and non-surgical treatments have failed, your doctor may recommend knee replacement surgery.

Types of Knee Replacement Surgery

There are several different types of knee replacement surgeries, depending on the severity of the condition and the patient’s needs:

1. Total Knee Replacement (TKR):
   • In total knee replacement, both the femur and tibia are replaced with prosthetic components, along with the damaged cartilage beneath the kneecap.
   • TKR is often recommended for patients who have severe arthritis or joint damage that affects the entire knee joint.
2. Partial Knee Replacement (PKR):
   • In partial knee replacement, only the damaged part of the knee is replaced, leaving the healthy parts intact. This procedure is suitable for patients with limited damage to one part of the knee, such as the inner or outer compartment.
   • PKR offers a faster recovery time and a more natural feel, but it may not be suitable for individuals with more widespread damage.
3. Kneecap Replacement (Patellofemoral Arthroplasty):
   • This type of surgery focuses solely on replacing the damaged surface of the kneecap, which may be an option for people with isolated problems in the patellofemoral joint (the joint between the kneecap and the femur).
4. Robotic-Assisted Knee Replacement:
   • Robotic-assisted surgery uses advanced technology to help guide the surgeon during the procedure. The robot allows for precise placement of the implant, which can improve alignment and reduce the risk of complications.

Preparing for Knee Replacement Surgery

Before undergoing knee replacement surgery, several steps are taken to ensure that you are a good candidate for the procedure. Your doctor will:

1. Evaluate your medical history: A complete medical history will help assess if there are any underlying conditions that could affect surgery or recovery.
2. Conduct physical examinations and imaging tests: X-rays, MRIs, or CT scans of your knee joint will help the surgeon determine the extent of damage.
3. Discuss anesthesia options: Knee replacement surgery is typically performed under general anesthesia or regional anesthesia (nerve blocks).
4. Review post-surgery rehabilitation: The doctor will discuss the rehabilitation process, which includes physical therapy and exercises to regain strength and mobility after surgery.

The Knee Replacement Procedure

The surgeon makes an incision over the knee to access the joint and remove the damaged cartilage and bone. The prosthetic components are then carefully placed and aligned to mimic the natural function of the knee. Once the prosthesis is in place, the incision is closed, and the knee is bandaged.

In some cases, a drain may be placed in the knee to remove any excess fluid, and the patient is moved to the recovery room for observation.

Recovery and Rehabilitation

Recovery from knee replacement surgery varies from patient to patient, but most individuals experience a significant improvement in pain levels and mobility within a few months. Here's what to expect during the recovery process:

1. Hospital Stay:
   • Typically, patients stay in the hospital after surgery, depending on the type of knee replacement and their overall health.
   • Pain management will be a priority during this time, and the medical team will help manage discomfort with medications and ice therapy.
2. Physical Therapy:
   • Rehabilitation begins soon after surgery to restore knee function and strength. Physical therapy is crucial to regaining full mobility and involves exercises to improve range of motion, strengthen muscles, and reduce swelling.
   • You may be encouraged to start walking with the help of a walker or crutches within a day or two of the surgery.
3. Follow-up Appointments:
   • Your doctor will schedule follow-up visits to monitor your progress and ensure the knee is healing properly. X-rays will be taken to check the positioning of the prosthetic.
4. Long-Term Recovery:
   • Full recovery from knee replacement surgery can take several months. Most patients can return to light activities after 6 to 8 weeks, while more strenuous activities may take up to 6 months or longer.
   • Maintaining a healthy weight, staying active, and continuing exercises will help ensure the longevity of the knee implant.

Risks and Complications

While knee replacement surgery is generally safe, like any surgical procedure, it carries some risks, including:

• Infection: Although rare, infections can occur at the surgical site or within the joint.
• Blood Clots: Blood clots can form in the legs after surgery, which may cause complications if not treated.
• Implant Loosening: Over time, the prosthetic may become loose, requiring additional surgery.
• Nerve or Blood Vessel Damage: Although uncommon, damage to nerves or blood vessels can occur during surgery.

Conclusion

Knee replacement surgery is a highly effective procedure that can greatly improve quality of life for those suffering from chronic knee pain and joint degeneration. By understanding the types of knee replacements, the preparation and recovery process, and potential risks, patients can make informed decisions about their treatment.

If you are considering knee replacement, be sure to consult with the best orthopedic surgeon, Dr. Martha Balakrishna, to determine the best approach for your needs. With proper care, knee replacement can restore mobility and reduce pain, allowing you to enjoy a more active, pain-free life.