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Total Knee Replacement

Total Knee Replacement: Overview, Preparation, Procedure, Recovery, Risks, and Aftercare

Overview

A total knee replacement is a surgical procedure that replaces a damaged or diseased knee joint with an artificial prosthesis, also known as total knee arthroplasty. When an individual suffers from severe arthritis or significant knee joint damage that causes persistent pain, stiffness, or limited mobility, this procedure is commonly recommended.

Preparation

In order to prepare for total knee replacement surgery, patients may need to:

  • An orthopedic surgeon specializing in joint replacement will meet with the patient to discuss their symptoms, medical history, and treatment options. A surgeon will determine whether total knee replacement is the most appropriate treatment during the consultation after evaluating the extent of knee joint damage.

  • As part of the preoperative evaluation, patients may undergo blood tests, X-rays, MRI scans, and electrocardiograms (ECGs) to assess their overall health and identify any potential risks or contraindications to surgery.

  • To minimize the risk of bleeding or complications during surgery, patients may need to adjust their medications, particularly blood thinners or anti-inflammatory drugs.

  • Patients may benefit from preoperative physical therapy to strengthen the muscles around the knee joint and improve range of motion, which facilitates postoperative recovery.

Procedure

Typically, total knee replacement involves the following steps:

  • Anesthesia: Patients are either given general anesthesia, which induces unconsciousness during surgery, or regional anesthesia, such as spinal or epidural anesthesia, which numbs the lower body while the patient remains awake.

  • To access the damaged knee joint, the surgeon makes an incision over it, typically along the front or side.

  • The damaged cartilage and bone in the knee joint are removed, and the femur (thigh bone) and tibia (shin bone) are reshaped to accommodate the artificial knee components.

  • A plastic spacer and the metal femoral and tibial components are securely implanted into the prepared bone surfaces using bone cement or press-fit techniques.

  • Sutures or staples are used to close the incision, and a sterile dressing is applied.

Recovery

In the aftermath of total knee replacement surgery, patients can expect the following recovery process:

  • After surgery, most patients remain in the hospital for a few days to monitor their pain, mobility, and recovery.

  • In physical therapy, patients learn exercises to improve muscle function, balance, and walking ability after surgery to help them gain strength, flexibility, and mobility in the knee joint.

  • In order to reduce swelling and inflammation, patients are encouraged to use ice packs, elevation, and compression to manage postoperative discomfort.

  • Under the guidance of their healthcare provider, patients slowly increase their activity level and weight-bearing on the operated knee. Full recovery and return to normal activities may take several weeks to months.

Risks

While total knee replacement surgery is generally safe, it does carry some risks and potential complications, including:

  • The surgical site or surrounding tissues may become infected, requiring antibiotic treatment or additional surgery.

  • After surgery, blood clots (deep vein thrombosis) can form in the legs and travel to the lungs (pulmonary embolism), posing a serious health threat.

  • Wear or loosening of the artificial knee components may require revision surgery to replace or repair the implants over time.

Aftercare

The following guidelines should be followed by patients following total knee replacement surgery:

  • For optimal knee function and mobility, attend all scheduled physical therapy sessions and perform prescribed exercises regularly.

  • In order to manage pain, prevent blood clots, and prevent infection, take prescribed medications as directed by your healthcare provider, including pain relievers, blood thinners, and antibiotics.

  • Attend all follow-up appointments with the orthopedic surgeon to monitor healing, assess knee function, and address any concerns.

  • During the initial recovery period, avoid high-impact activities, heavy lifting, and strenuous exercise that could strain the knee joint. Gradually resume normal activities as tolerated.

Patients can achieve successful outcomes and regain mobility and quality of life by understanding total knee replacement, preparing appropriately, and following recommended aftercare guidelines.

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