Surgical Information - Procedures

Total Knee Replacement

What is total knee replacement?

Total knee replacement is a surgical procedure to replace the weight–bearing surfaces of the knee joint. The most common reasons for knee replacement surgery are to relieve pain and replace joint cartilage damaged by osteoarthritis, rheumatoid arthritis and a variety of other conditions that lead to arthritis of the knee.

During total knee replacement, the surgeon removes damaged cartilage surfaces at the ends of the    femur (thighbone) and tibia (shinbone) and replaces them with an implant called a prosthesis. A plastic spacer is attached to the prosthesis to create a cushioning effect much like the original cartilage in your knee.

Today, most knee replacement surgeries are minimally invasive, with numerous benefits to the patient. These include smaller incisions, less tissue trauma, bleeding and post–operative pain, shorter hospital stays, faster recovery, and earlier return to work and activities

One of the most innovative techniques is muscle–sparing knee replacement, which combines the latest minimally invasive methods with a surgical approach that leaves key muscles and tendons intact. Instead of cutting the major knee tendons, the surgeon makes a three– to five–inch incision on the knee and splits or dissects under the quadriceps muscle and tendon. Because the incision is very small and the quadriceps extensor mechanism is intact, patients are able to lift and bend their leg within the first hours after surgery. This technique also results in much less knee pain and blood loss.

Anatomy

The knee is the largest joint in the body and one of the most complex. It is made up of the femur, tibia and patella (kneecap). Articular cartilage covers the ends of the bones and allows them to glide smoothly over one another. Osteoarthritis and rheumatoid arthritis cause the surface layer of cartilage to wear away. Without this cushioning effect, the bones of the knee joint rub together. The knee can't move easily and becomes stiff, swollen and painful.

When is surgery recommended?

If you have knee pain that limits your everyday activities, secondary to arthritis, and all non-surgical methods of treatment have failed — including weight loss, anti-inflammatory medications, cortisone injections, lubricating injections and physical therapy — then you should consider surgery.

Knee replacement surgery is now much less invasive, with less tendon and muscle trauma, less bleeding, less pain and less life interruption. Patients recover much more quickly and return to work and activities within weeks rather than months.

Most patients with advanced knee arthritis are considered good candidates for minimally invasive total knee replacement surgery. However, each patient should be carefully screened to determine the most appropriate type of procedure.

What is the recovery time?

Minimally invasive approaches, improved implant material and design, and refined surgical techniques have dramatically reduced recovery time. For these patients, the typical recovery period is now weeks rather than months. Most patients are up and walking immediately following surgery and regain range of motion, strength and flexibility after several weeks of physical therapy. Hospital stays have been reduced to one or two days and the vast majority of patients can go directly home without having to use a rehabilitation center.

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