Knee joint consists of a joint between lower end of thigh bone (Femur) and upper end of shin bone (Tibia). The knee cap (patella) also makes a joint with the lower end of thigh bone and is called patello-femoral joint. The surfaces of joints are covered with thin shiny white layer of cartilage which is lubricated by the joint fluid which helps in smooth and pain-free motion at joints. Damage to this shiny layer of cartilage leads to irregularity of the joint surface which cause pain and with time results in permanent irregularity of the joint surface resulting in decreased joint motion, paining and crackling sound while moving the joint. Early stages can be managed with pain relieving medications, weight reduction, and exercises to strengthen the muscles around knee joint. In advanced cases there is permanent loss of motion and development of lower limb deformities. Once the pain is significant resulting in limitation of daily routine activities like walking, climbing stairs, sitting cross leg along with development of deformities, knee replacement can be done to regain the pain-free motion. It is a safe and effective treatment to get rid of pain and disability. Knee replacement can be done for whole of the joint (Total Knee replacement) or some part of the joint (Partial Knee replacement).

Knee replacement is done under regional ( where only your lower limbs are numb and you are awake) or General Anaesthesia ( where you are made to fall asleep till the surgery is complete ) which will be decided by the Anaesthesiologist depending on your current health condition . A tight pneumatic bandage (tourniquet) is applied to your thigh so as to stop bleeding during surgery. A 15-20cm incision is given over the centre of knee and the joint surfaces are exposed. The extra bony overgrowths (Osteophytes) are excised. The damaged joint surfaces are removed and the deformity is corrected so as to obtain near normal limb alignment. New joint surfaces are created using metal bearing surfaces one for the lower end of thigh bone ( femoral Component ) and one for the upper end of shin bone ( Tibial Component ) with a piece of plastic insert ( Highly cross linked polyethylene ) is inserted between the tibial and femoral component. A cement is used to fix these implants to the bone surfaces. The new joint is thus created between the femoral component and plastic insert provides pain-free movements at knee joint. Patello-femoral joint replacement depends on the damaged to patellar joint surface. At Orthoexcellence the patellar replacement is done less often. Finally the joint motion and alignment is checked and surgical field is washed with sterile fluid and sutured using absorbable sutures. At Orthoexcellence we also offer suture less knee replacement. A plastic tube may be placed in the knee joint to remove the blood collection in knee joint. A compression bandage is applied and knee placed in a long knee brace to keep the limb straight. The tourniquet is deflated. Once you are awake you will be shifted to recovery room.

After total knee replacement you will be given antibiotics, pain medications and ice packs for few days. Wound dressings will be required till all the sutures are removed. A long knee brace is to be worn for 4 to 6 weeks after surgery. Walking is allowed to all the patients after 48 hours only with walker till the patient regains muscle strength and power in the lower limb. Walking with stick can be stated as early as possible and as and when you are comfortable with it. Almost all patients are discharged after 5 to 7 days after surgery depending upon the recovery. Bathing is only allowed after suture removal. Rehabilitation begins immediately after surgery and an aggressive Orthoexcellence rehab protocol followed and advised to every patient which is followed till the patient regains muscle strength and knee motion while at home.

Knee replacement is a major surgery and as with any major surgery it also has complications and risks as mentioned below:-

• Bleeding in the joint which may require blood transfusion
• Infection
• Knee stiffness
• Blood clots in legs (DVT)
• Blood vessels or nerve injury
• Ligaments damage
• Wear of plastic insert
• Loosening of metal parts

The content, information, opinions, viewpoints and advice contained herein is solely provided to promote patient education. It doesn’t replace the advice of your qualified doctor or health-care professional. Orthoexcellence team makes every effort to provide accurate knowledge to the patients but cannot provide guarantee as to the completeness and accuracy of the information provided in this website.