Total knee replacement

What is a total knee replacement?

Total knee replacement is a surgical procedure which allows damaged joints to be replaced with artificial components - usually made from metal and polyethene. Materials like acrylic cement can also be used in the procedure. Total knee replacement surgery is among the most common surgeries involving the bones.

In the process of a total knee replacement, the surfaces of both the thigh bone and the shinbone are replaced.

Am I a good candidate for a total knee replacement?

You are generally a good candidate for total knee replacement surgery if your knee joint has become damaged, leading to progressive pain and an impaired function.

Osteoarthritis is among the most common reasons for total knee replacement being needed. This is a condition that involves the deterioration of the cartilage, leading to insufficient cushioning for the knee joint. You may also be a suitable candidate for total knee replacement if you have rheumatoid arthritis, or have broken a bone.

How does total knee replacement surgery work?

Either regional anaesthetic (which numbs your body from the waist down) or general anaesthetic (which makes you unconscious) would be administered for a total knee replacement. An intravenous antibiotic is given before the procedure, as well as during and after it. You could also be given a nerve block to numb your knee. The numbness subsides gradually following the operation.

During the procedure itself, your knee would usually be put in a bent position in order to expose all of the joint's surfaces. The surgeon will begin by making an incision around six to ten inches long before the kneecap can be moved aside and the damaged joint surfaces can be cut away. Then the surgeon secures the artificial joint pieces. He or she will rotate the knee to test its function before the incision can be closed. Total knee replacement usually takes around two hours to complete.

Recovery from a total knee replacement

Following the procedure, you would typically be taken to a recovery room for about two hours, before moving to a hospital room where you will stay from one to two days. You may be prescribed medication by your doctor in order to relieve pain. You will receive instructions on moving your ankle and foot while in hospital care, to help prevent blood clots and swelling while increasing blood flow to the leg muscles. You would usually be asked to perform breathing exercises and slowly increase your level of activity.

You will typically be given a compression boot to wear in order to guard against clotting and swelling, as well as receive blood thinners.

A physical therapist will demonstrate exercises which will gradually strengthen the knee and improve range of motion. After you leave hospital, your physical therapy programme will continue; either at a specific centre or at home. For the best recovery, it is important to carefully follow your exercise programme, as well as follow other instructions relating to diet and wound care.

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