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Basic Steps of Total Knee Replacement Surgery

24th Apr 2021

Knee pain is a common problem for many people as the bones and joints work together to support the weight of our body while we move about performing some of our daily tasks. It can be aggravated by physical activity as well as obesity, affecting the surrounding muscles and their movements.

On top of that, the pain can originate in any of the bony structures compromising the knee joint (femur, tibia, fibula), the kneecap (patella), or the ligaments, tendons, and cartilage (meniscus) of the knee. Treating knee pain with home remedies can be helpful but once it becomes a severe problem, total knee replacement surgery may be recommended.

Total Knee Replacement Surgery Procedure: Must Know

Total knee replacement surgery, also known as knee arthroplasty, is a surgical procedure that can help relieve knee pain and restore function in severely diseased knee joints. The surgery involves cutting away damaged bone and cartilage from the thighbone, shinbone, and kneecap and replacing it with an artificial joint (prosthesis) made of metal alloys, high-grade plastics, and polymers.

Whether you’ve chosen to undergo a knee replacement or looking to understand your options, an orthopaedic surgeon will first assess your knee’s range of motion, stability, and strength along with some X-ray imaging to help determine the extent of the damage. Total knee replacement surgery may be considered if you have severe arthritis or a severe knee injury.

Reasons for Total Knee Replacement Surgery

The main goal of total knee replacement surgery is to resurface parts of the damaged knee joint and relieve knee pain that can’t be controlled by other treatments such as physical therapy, medications, and injections.

There are various types of arthritis that can affect the knee joint with osteoarthritis affecting most middle-aged and older adults. It’s characterised by the breakdown of joint cartilage whereby damage to the cartilage and bones limits movement and may cause pain. People with osteoarthritis may have a hard time doing activities that involve bending the knee like walking or climbing stairs.

Aside from osteoarthritis, rheumatoid arthritis can cause inflammation of the synovial membrane and result in excessive synovial fluid, leading to pain and stiffness of the knee. Meanwhile, traumatic arthritis, as the name suggests, is due to injury which may cause damage to the cartilage of the knee.

If medical treatments aren’t satisfactory, a knee replacement surgery is often recommended due to its effectiveness.

Risks of Total Knee Replacement Surgery

Like any other surgical procedures, there are risks to total knee replacement surgery. Some of these include:

  • Infection may occur in the wound or deep around the artificial joint (prosthesis). This may happen within days or weeks after the surgery. Minor infections can be treated with antibiotics, but major or deep infections require revision surgery to treat the infection.
  • Blood clots in the leg veins are one of the most common complications of knee replacement surgery. It can be life-threatening if the clots break free and travel to the lungs. The surgeon will outline a prevention programme to increase blood circulation.
  • Implant problems may surface over time despite the use of high-quality material and intricate designs. The implant surfaces may also wear out and components may loosen due to constant motion.
  • Continued pain after a knee replacement surgery is rare but some patients may experience it.
  • Neurovascular injury is rare but can occur during surgery.

There may be other risks depending on your medical condition. Make sure to discuss any concerns with your doctor before the procedure.

Steps of Total Knee Replacement Surgery

Knee replacement surgery typically involves multiple steps. You’ll first be given anaesthesia and once it has taken effect, the skin around your knee will be thoroughly scrubbed with an antiseptic liquid. Your knee is then flexed at about 90 degrees and the lower portion of your leg is placed in a special device to hold it in place during the surgery.

#1 Making the knee incision

The surgeon makes an incision across the front of your knee to gain access to the kneecap and rotates the kneecap outside the knee area. This is necessary so that the surgeon can view the area needed to perform knee arthroplasty.

#2 Preparing the bones

In total knee replacement surgery, all three compartments of the knee are resurfaced to ensure the artificial joint fits well into the bones. The surgeon will carefully measure the bones and make precise cuts using special instruments.

#3 Implanting the components

After preparing the bones, the surgeon attaches the respective artificial components to the ends of the bones and uses bone cement to seal them into place. Once the components are in place, the surgeon will snap in a polyethylene insert between the tibial tray and femoral component to act as a buffer. It’ll work to provide support to your body as you bend and flex your knee.

#4 Re-adjusting the kneecap

Before readjusting the kneecap to its original position, the surgeon might need to flatten the kneecap and fit it with an additional plastic component to ensure a proper fit with the rest of your implant. If needed, the plastic component may be cemented to the underlying bone.

#5 Finalising the procedure

To ensure that the implant is working correctly, the surgeon will bend and flex the knee to examine whether the alignment, sizing, and positioning of the implant is suitable. Your surgical procedure is complete when the surgeon closes the incision with stitches or staples and bandages it and prep you for recovery.

A total knee replacement complications may be effective in relieving your knee pain and restoring mobility function, but your knee won’t work the same as your natural knee. Hence, you must maintain good ligament health to prevent knee surgery. Once your ligament and tendon are damaged, they take time to heal.

At Spire Orthopaedic Centre, everyone should be cared for and healed holistically in comfort without having to travel to different locations to seek medical and surgical help and rehabilitation support.

With a combined facility for collaboration between physicians, physiotherapists, and surgeons, you will experience a seamless service from diagnosis to treatment and rehabilitation, that’s tailored just for you at our clinic.