Knee Replacement Surgery

What is a Knee Replacement?

Knee replacement surgery also known as knee arthroplasty involves replacing parts of a damaged or worn-out knee joint by metal and plastic implants. Knee replacement surgery provides relief from pain and helps the knee move better. 

The surgeon evaluates the extent of damage, range of motion, stability, and strength of your knee to determine whether a knee replacement may be suitable for you. X-rays can provide a good indication of the extent of damage. The goal of the procedure is to help you return to daily activities with relief in pain and greater mobility.

Factors such as age, weight, activity level, knee deformity and overall health generally determine the type of artificial joints and surgical techniques needed.

Who Can Benefit from a Knee Replacement Procedure?

For someone who suffers from chronic knee pain, disability or severe joint damage; knee replacement can be life-changing. It is usually recommended when all non-surgical treatments have been tried or the knee joint has significantly deteriorated. Some common conditions that may require knee replacement include:

• Osteoarthritis (OA)
• Rheumatoid Arthritis (RA)
• Post-Traumatic Arthritis
• Severe Knee Injuries
• Failed Previous Knee Surgery
• Knee Joint Tumours

Types of Knee Replacement Surgery

Knee replacement surgeries are classified based on the extent of the procedure and the parts of the knee joint being replaced:

Partial Knee Replacement (Unicompartmental Knee Replacement)

There are basically three compartments of the knee: the inner, the outer, and the front or the  patellofemoral compartment. If arthritis is limited to only one part of your knee, usually the inner side, a half-knee replacement, also known as unicompartmental or partial replacement, may be possible. 

Partial knee replacements can be done with a smaller incision than a total knee replacement that decreases the time spent in recovery. Partial knee replacement is a less stressful operation with lesser pain and risk of bleeding and can be considered at any age.

Total Knee Replacement (Total Knee Arthroplasty)

Total knee replacement involves replacing the lower end of your thigh bone (femur) and the top  surface of your shin bone( tibia). It may also involve replacing the under-surface of your kneecap or patella, with a soft plastic dome. However, surgeons at times preserve the natural patella, especially when it's still in a healthy condition.

The new parts are usually fixed to the bone with a special glue known as bone cement. When bone cement is not used, the surface of the component facing the bone is etched or coated to stimulate bone growth, thus creating a natural bond.

Knee-cap Replacement (Patellofemoral Arthroplasty)

A knee-cap replacement requires only the underside of the knee-cap and its groove (the trochlea) to be replaced if these are the only problem areas for someone with arthritis. The procedure is only appropriate for around 1 in 40 patients who have osteoarthritis.

Complex primary Knee Replacement

The main reasons for this are:

• extensive bone loss due to either arthritis or fracture
• severe deformity of the knee
• weakening of the major knee ligaments.

Revision Knee Replacement: It is usually required in cases of failure of primary knee surgery that can either be due to wear and tear of implants with time or due to any complication with the primary surgery.

Complex Primary/ Revision knee replacements will commonly have a longer stem that ensures the component is firmly attached to the bone cavity. The components may also interlock centrally through the knee to create a hinge for enhanced stability. Extra pieces of metal and/or plastic are often used to compensate for any bone that may have been removed or badly damaged.

What Happens During a Knee Replacement Procedure?

A standard knee replacement surgery procedure is as follows:

1. Preparation:  General anesthesia or regional anesthesia will be used for the procedure so that you are comfortable during the surgery.There may also be a urinary catheter placed to manage your bladder during surgery. 
2. Preparing the Surgical Site: The surgical team will prepare the knee area by cleaning it with an antiseptic solution to minimize the risk of infection. If the surgical site has hair, it would be clipped and cleaned to provide a clear area for the incision.
3. Damage Tissue Excision: The surgeon will make an incision in the knee region to access the joint to view the damaged cartilage and other structures of the knee joint. The type and extent of the procedure will depend on the joint's condition and the surgeon's evaluation.
4. Implanting the Prosthesis: Once the damaged tissue has been removed, the surgeon will prepare the surfaces of the knee joint for the prosthesis. The prosthesis typically includes three components:
5. Tibial component, that resurfaces the top of the shinbone.
6. Femoral component that resurfaces the end of the thigh bone.
7. Patellar component, which resurfaces the underside of the kneecap.
8. The metal and plastic prosthesis is often fixed to the bone using surgical cement, though cementless fixation may also be employed.

Closing the Incision: Once it is ensured that the new joint is aligned and working properly, the surgeon will close the incision with stitches or surgical staples. Sometimes, a drain may be inserted into the site to drain out the extra fluid. Lastly, a sterile bandage or dressing is applied to the area to prevent infections and support healing.

Post-Procedure Care and Recovery After Knee Replacement Procedure

A physical therapist will visit you on the day of surgery and begin an individually tailored exercise program to restore the knee function.  

Medications will be used to control your pain so that you can tolerate the physical therapy program. Once discharged, our professionals will organize the follow-up care and physical therapy to have an effective recovery after you return home.

At Home

Once you are back home, these recommendations will help ensure that your recovery is hassle-free:

• Take Care of the Incision: Keep the surgical area dry and clean, according to your doctor's direction. Stitches or staples will be removed by your healthcare provider at a follow-up visit.
• Managing Swelling and Pain: Minimize swelling and pain by elevating your leg and applying ice as instructed. Only take the prescribed or approved pain relievers to avoid complications.
• Diet and Activity: Resume your regular diet unless otherwise instructed. Avoid driving and follow any activity restrictions recommended by your physician.

Preventing Falls and Home Safety

Protect your new joint by preventing falls. Your physical therapist may advise utilizing an assistive device like a walker until your strength and balance improve. 

Why Choose Marengo Asia Hospitals?

The Department of Orthopaedics, Joint Replacement & Spine Surgery at Marengo Asia Hospitals provides state-of-the-art treatments for diseases related to joints, spine, and bones. Our experienced surgeons use advanced techniques in knee replacement and other joint replacement procedures. A partial or total knee replacement is carried out with all state-of-the-art techniques, making sure that each patient under treatment receives the best possible individualized care.

If you have pain, stiffness, or reduced mobility in the knee that lasts more than a few days, visit Marengo Asia Hospitals for consultation with our expert surgeons. They can help you to know about treatment options such as knee replacement surgery to restore movement and improve quality of life.