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Total Knee Replacement

Total knee replacement is a surgical procedure in which injured or damaged sections of the knee joint are replaced with artificial parts. It is commonly performed for arthritis of the knee where the joint has become stiff and painful. Initially, Arthritis can be treated with painkillers, anti-inflammatories, physiotherapy and, in the earlier stages, arthroscopy (keyhole surgery) but as the knee progressively wears, joint replacement surgery may be required to relieve the pain and improve mobility.

What happens in surgery?

The surgery involves removing a small thickness of the damaged bone at the end of the femur (thigh bone), tibia (shin bone) and the back of the patella (kneecap). Generally, about a centimetre of bone is removed during the operation. The knee replacement fits inside the space and is fixed to the bone with cement.

The operation takes about an hour and involves a 15-20cm incision over the front of the knee, which is closed at the end of the operation with either clips or an absorbable suture. There will be two drains fitted to the wound and the blood drained can be given back to you, which can reduce the need for a blood transfusion from the blood bank.

Total Knee Replacement

The component parts of the TKR

The Total Knee Replacement comes in 3 parts. The Femoral component is made of metal and is highly polished. The Tibial component is made of metal with a curved plastic tray attached to its upper surface. This forms the new joint with the metal femoral component. The back of the patella is covered with a plastic button, which sits in a shallow groove on the front of the metal femoral component.

After a Total Knee Replacement

The day after the operation your exercise regime begins. With the aid of a physiotherapist you will get out of bed and begin to exercise your new knee replacement. With perseverance, you should be able to climb stairs by day 4 or 5 and go home the following day.

You will need to continue attending physiotherapy as an outpatient. This can be done closer to your home with one of our recommended group of physiotherapists.

For most people it will take around 6 weeks to be walking reasonably with only one stick. After six months you should be able to walk well without pain, climb stairs (leading with your operated leg) and be capable of a range of movement with your new knee from 0 degrees to at least 100 degrees.

It is important to remember that an artificial knee is not a normal knee. You may well be able to carry out many normal activities of daily living. However, this range of movement may not be as good as it was before surgery and you may never be able to kneel after your knee replacement.

Lifespan of the TKR

Studies suggest that a Total Knee Replacement in a 70 year old has around a 94% probability of lasting for 10 years after surgery. If, however, the patient is younger and more active the replacement may not have such a high survival rate. Other treatments such as osteotomy may be better in younger patients as knee replacement can then be put off for several years.

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