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Total Knee Replacement Surgical Procedure

21st Apr 2021

Oftentimes, you hear your elderly parents complaining of knee pain or you may experience some pain in the knee. For mild to moderate knee pain, home remedies may work to relieve the pain.

While certain causes of knee pain such as inflammation, arthritis, or a minor injury can be resolved without medical help, there are times when the pain levels may increase, causing you or your parents to feel extremely uncomfortable.

That said, seeking medical attention is the last thing anyone wants because that would mean multiple visits to the clinic, a high treatment cost, and prolonged recovery time.

If you’re one of those few people who dislike going to the clinic, there are various alternatives to a total knee replacement surgery such as losing weight to lessen the stress on your knees, trying low impact exercises for strength and mobility, and using pain medications.

Bear in mind that these alternatives are only effective if you experience mild to moderate knee pain. If you experience severe pain in the knee, it’s best to seek proper medical attention so that you won’t have to suffer from the pain.

That said, the main benefit of a total knee replacement include being able to walk or performing your daily tasks without feeling severe pain in the knee. In some cases, it provides a better treatment response to certain causes of knee pain such as chronic knee inflammation and swelling, which reduces the need for medication and other surgeries.

The most common reason for a total knee replacement surgery is to relieve pain and restore function caused by osteoarthritis that’s affecting a great deal of middle-aged and older people. It’s characterised by the breakdown of joint cartilage whereby damage to the cartilage and bones limits the movement and causes pain in the knee.

Additionally, other forms of arthritis such as rheumatoid arthritis and arthritis that results from a knee injury can lead to the degeneration of the knee joint. Fractures, torn cartilage, and/or torn ligaments can also lead to irreversible damage to the knee joint.
Risks of total knee replacement surgery
Like any other surgical procedures, there are possible complications such as bleeding, infection, blood clots in the legs or lungs, loosening or wearing out of the prosthesis, fracture, continued pain or stiffness.

Aside from these complications, the replacement knee joint may become loose, be dislodged, or may not work as it was intended, which may have to be replaced again in the future.

Nerves and blood vessels in the area of surgery may be injured, resulting in weakness or numbness. Also, there may be other risks involved throughout the procedure, depending on your medical condition.

Total Knee Replacement Surgery, Recovery Time, and Risks

Depending on the condition of your knee and the severity of the damage caused by arthritis, an orthopaedic surgeon will first assess your knee’s range of motion, stability, and strength using X-ray imaging to determine the type of knee replacement surgery.

There are two types of knee replacement surgeries – total and partial. Throughout this article, we focus on total knee replacement surgery, the recovery time, and surgical risks.

Surgical Procedure

A total knee replacement, also known as knee arthroplasty, is a surgical procedure to resurface a knee damaged by arthritis. It works to relieve pain and restore function in severely diseased knee joints.

Generally, the procedure involves cutting away damaged bone and cartilage from the thighbone (femur), shinbone (tibia) and kneecap (patella) which is then replaced with an artificial joint (prosthesis) made of metal alloys, high-grade plastics and polymers.

During the procedure, an orthopaedic surgeon resurfaces the damaged bone and replaces it with an artificial implant that fits the bone anatomy. The surgeon uses special surgical instruments to accurately cut the arthritic bone and shape the healthy bone underneath to fit precisely into the implant components.

A total knee replacement surgery is a multiple-step procedure. The first part involves preparing the bone by removing the damaged surfaces on the thighbone and shinbone. In the next step, the surgeon inserts the implants accordingly and either cement them to the bone or press-fits them.

The following step involves inserting a plastic button under the kneecap whereby the surgeon implants a medical-grade plastic spacer between the tibial and femoral components to create a smooth surface that glides easily. For a successful outcome, the surgeon must realign the implants accurately and fit them carefully to the bone.


The recovery time for this type of surgical procedure typically takes weeks if not months, but for a full recovery, it may take up to a year. After the surgery, you’ll be put under observation until the anaesthesia wears off. Once your vitals are stable, you’ll be taken to your hospital room where you’ll stay for several days.

Since it’s crucial to move your artificial joint after the surgery, a physiotherapist will plan an exercise programme for you. A continuous passive motion (CPM) machine may be used to initiate your physical therapy. The machine works to move your new knee joint through a range of motion while you rest in bed. Medication may be necessary to control the pain.

Once you’re discharged, you’ll have to continue your physical therapy either at home or a rehabilitation centre until you regain muscle strength and a good range of motion. You also have to keep the surgical area clean and dry based on your doctor’s bathing instructions.

If your new knee joint shows signs of swelling, elevate your leg or apply ice to it. Relieve soreness with the pain reliever recommended by your doctor. Avoid aspirin or other pain medications as they may increase the chance of bleeding. Make sure to notify your doctor if you have a fever or experience increased pain around the surgical area.

Three to six weeks after your surgery, you can generally resume your daily activities such as shopping and light housekeeping. Driving may be possible unless you’re advised otherwise by your doctor. You can also engage in low-impact activities such as walking, swimming, golfing, or biking. But avoid activities that involve contact or jumping during your recovery


Like any other surgical procedure, a total knee replacement surgery has its risks. This includes bleeding, infection, blood clots in the legs or lungs, loosening or wearing out of the prosthesis, fracture, continued pain and stiffness.

If you notice some drainage from the surgical site or experience some redness, tenderness, swelling and pain in the knee, notify your doctor immediately as you may have to undergo another surgery to remove the artificial parts and antibiotics to kill the bacteria. Once the infection is cleared, another surgery is performed to install a new knee.

Another risk of a total knee replacement surgery is the failure of the artificial joint. Daily use can wear out even the strongest metal and plastic parts. If you stress your new joint with high-impact activities or excessive weight, joint failure risk is higher. Hence, longer recovery time.

Anaesthetic Techniques for Total Knee Arthroplasty

Before any joint replacement surgery, anaesthesia is necessary but the selection requires careful consideration as it can have a significant impact on recovery. When it comes to the selection of anaesthesia, the doctor will consider these factors:

  • Past experiences and preferences
  • Current health and physical condition
  • Reaction to medication
  • Risks involved
  • Healthcare team

There are three categories of anaesthesia – local, regional, and general. The first type only numbs a specific area as the patient remains conscious during the procedure. This technique is generally reserved for minor procedures but for major surgeries such as hip or knee replacement, local anaesthesia may be used to complement the main anaesthesia.

Regional anaesthesia involves blocking the nerves to a specific area of the body, without affecting your brain or breathing. You’ll be given sedatives to make you fall into a light sleep throughout the surgery. There are three common types of regional anaesthesia
– spinal block, epidural block, and peripheral nerve block.

Unlike the previous categories of anaesthesia, general anaesthesia is often used for major surgery such as a joint replacement. It generally affects your entire body, as it acts on the brain and nervous system and renders you temporarily unconscious. Also, it’s usually administered through injection or inhalation.

However, there are risks to using any anaesthesia, especially if you have heart disease, chronic lung condition, or other serious medical problems. Hence, you should discuss with your surgeon and anaesthesiologist during the selection.

A total knee replacement surgery may seem helpful but your knee won’t work the same as your natural knee. Once your ligament and tendon are damaged, they heal slowly. What you can do is keep a balanced diet to strengthen your tendons and ligaments.

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.