Procedure Description

Total knee replacement (also known as total knee arthroplasty–TKA) is an operation that relieves chronic pain from knee arthritis in patients who undergo the procedure. It can also improve the range of motion, although mild limitations in knee bending may persist after surgery.

TKA was typically done through a 6-10 inch incision down the front of the knee. However, with the advent of minimally invasive surgical techniques (MIS), total knee replacements can now be done through 3 ½ – 5 inch incisions, and partial (unicompartmental) knee replacements through 2-3 inch incisions. Minimizing the deep soft tissue dissection, more than minimizing the length of the incision, reduces pain, shortens hospital stays, and hastens recovery. 

Knee replacement surgery removes the diseased joint surfaces, restores the leg to a straight position, and permits the knee to move smoothly again. Most patients require several weeks of physical therapy after their surgery in order to gain the best function from their knee.

Total knee replacement does not require removing and replacing the entire knee joint. Instead, the diseased surfaces of the joint are planed down by about ¼”, and each is carefully fitted with a polished metal cap, something like capping a tooth. A plastic “shim” slides between the 2 metal surfaces, restoring smooth, pain-free motion of the knee. The backside of the kneecap (patella) may also be shaved down and fitted with a smooth plastic cap if it is arthritic.

Patients check into the hospital on the day of surgery and usually stay for about two to three days. The surgery, itself, normally takes about one hour. Most patients are able to stand and take a few steps with a walker, on the day of surgery, with help from a physical therapist (PT). The PT will teach proper use of a walker or crutches, common activities such as using the toilet or entering and exiting a car, and basic exercises to improve motion and strength of the knee.

An occupational therapist (OT) may see the patient before hospital discharge in order to teach basic skills of washing, toileting, and dressing that accommodate the newly operated knee. Assistive devices may also be provided to the patient. The OT can also help plan for any challenges of daily living that the patient will face at home, such as feeding pets or doing occasional light laundry.

Today, almost all patients are able to return directly home after surgery, rather than going to a rehabilitation hospital. Patients who adhere to their daily exercise regimen can often return to most normal daily activities by 4-8 weeks.

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