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Overview

Knee Replacement: Procedure, Recovery, Cost, Risk & Complication

Knee replacement, which is also known as arthroplasty is a type of surgical procedure done to resurface the knee as a result of damage due to the onset of arthritis. The surgery is generally recommended for a patient who is suffering from a serious case of arthritis or an individual who have experienced a bad knee injury. The surgery, resurfaces the damaged part of the knee so as to reduce acute knee discomfort. This type of surgery is known to effectively reduce knee pain for almost 90% of the patients who opt for it. Knee replacement surgery is classified into 2 basic types-

  • Total knee replacement surgery- Through this procedure the knee joint is repaired with a metal covering that is placed on the thigh bone.
  • Partial knee replacement surgery- Through this procedure only the part of the knee that is damaged is repaired.

Indication

Knee replacement surgery is generally recommended to patients who have a severe case of osteoarthritis. It generally occurs with old age and the knee cartilage tends to break down because of the constant wear and tear. The onset of this condition hinders with knee movement and can cause acute pain. The condition may be treated through other methods like prescription of painkillers, physiotherapy and anti-inflammatory medication. But if such treatment is ineffective doctors generally recommend knew replacement procedure.

A knee replacement may also be advised in case of a severe injury to the joint due to an accident.

Pre Procedure

Before one undergoes the procedure, the doctor explains the proceedings in detail and you will have to sign a consent form. A detailed medical history is taken again and relevant tests are done. Make sure to inform your doctor about any allergies you have or medication that you are taking.

In order to prepare the patient for the operation, water and food is stopped some 8 hours prior the procedure. A sedative is given just before the procedure to help the patient relax. Patients are also asked to arrange for someone to help them with recovery for a couple of weeks post the procedure.

During Procedure

Knee replacement surgery is performed under the influence of anaesthesia. The procedure is as follows-

  • The patient is prepped for the surgery and brought into the operation theatre
  • The skin at the site of the incision is cleaned with an antiseptic, and a cut is made.
  • The damaged part of the knee is removed and resurfaced with prosthesis, which may be metal or plastic. The prosthesis used may be either cemented or un-cemented, or even a combination of both, depending on the patients requirement.
  • The incision is then closed and stitched up or stapled. A drain is generally placed at the site of the incision to facilitate easy removal of fluid. The surgical wound is dressed.

Post Procedure

Once the surgery is done the patient is shifted from the operation theatre to the recovery room, where he is monitored constantly. You may have to stay at the hospital for a few days after the surgery. During this period you will start physical therapy to help you gain back knee movement. During this period pain killers are also prescribed to bring down the pain and help with exercise.

Once you are discharged and go home, ensure that you take care of the surgical wound. It should be kept clean and dry. Specific instructions will be given about how you can bathe and clean up. The dressing is generally removed at the next check-up. In case you develop a fever, or experience acute pain and swelling inform your doctor immediately. You can go back to your normal routine as soon as your doctor says it is okay to do so.

Risk & Complication

All surgical procedures involve certain complications, and so does knee replacement. A patient should be aware of the various risks of the surgery before undergoing it. A knee replacement procedure involves complications like-

  • bleeding or onset of infection
  • formation of blood clots at the site of surgery or in the lungs
  • fracture or the prosthesis may become loose
  • acute pain and stiffness of the knee
  • Injury to nerve cells or blood vessels at the site of the surgery
  • There may be some other risks involved depending on the patient’s health and medical condition, which should be discussed with the doctor before the procedure.

    More Info

    Knee replacement procedure was first done during the 1970s. During that period doctors were of the opinion that a knee implant would last for 10 years. Today, knee implants have a life of about 20 years. In fact it has been predicted that by the year 2030 about 450,000 knee replacement procedures will be done each year.

    After the surgery the pain is reduced to a great extent and disappears in most cases. One can gradually go back to their normal daily activities and can even indulge in sports like golf, tennis, running and swimming without any problems. Quality of life is greatly improved.

Popular Health Tips

Know Everything About Knee Replacement

Dr. Rakesh G. Nair Nair 90% (15 ratings)
DNB (Orthopedics), Diploma in Orthopaedics, MBBS
Orthopedist, Mumbai
Know Everything About Knee Replacement
Knee replacement surgery also known as knee arthroplasty (ARTH-row-plas-tee) can help relieve pain and restore function in severely diseased knee joints. During knee replacement, a surgeon cuts away damaged bone and cartilage from your thighbone, shinbone and kneecap and replaces it with an artificial joint made of metal alloys, high-grade plastics and polymers. Why is it done? The most common reason for knee replacement surgery is to relieve severe pain caused by osteoarthritis. People who need knee replacement surgery usually have problems walking, climbing stairs, and getting in and out of chairs. Some also have moderate or severe knee pain at rest. The Procedure The procedure begins with you being administered general anesthesia, after which, an incision of 9-12 inches is made on the knee. The part of the joint that has been damaged is gotten rid of, following which the surfaces of the bone are redesigned to hold an artificial joint. Cement is used to attach the artificial joint to the shin, knee cap and the thigh bone. Once the fitting is complete, the artificial joint is supported by the surrounding muscles. Results For most people, knee replacement provides pain relief, improved mobility and a better quality of life. Talk with your doctor about what you can expect from knee replacement surgery. Three to six weeks after surgery, you generally can resume most daily activities, such as shopping and light housekeeping. Driving is also possible at around three weeks if you can bend your knee far enough to sit in a car and if you have enough muscle control to operate the brakes and accelerator. After you've recovered, you can enjoy a variety of low-impact activities, such as walking, swimming, golfing or biking. But you should avoid higher impact activities such as jogging, skiing, tennis and sports that involve contact or jumping. Talk to your doctor about your limitations. Aftercare The duration of the hospital stay is around 2-3 days. The effects of the surgery start becoming noticeable within a month of the surgery being carried out. Initially, you may require walking aids. It takes about 5-6 weeks to regain your ability to walk without any external or physical support. You will have to undergo physical therapy after the surgery to improve your muscle strength. The physiotherapist may prescribe various exercises to strengthen the muscles around the knees. You need to follow certain precautions after the surgery; squatting and kneeling become certain activities which you should avoid. Avoid activities that places undue stress on the knees.
3740 people found this helpful

Knee Osteoarthritis and PRP therapy

Dr. Poonam Patel Vasani 92% (886 ratings)
MBBS, MD - Anaesthesiology, FIPM, Fellowship in palliative medicine, certificate in interventional pain management
Pain Management Specialist, Pune
Knee Osteoarthritis and PRP therapy
Knee osteoarthritis is a common condition affecting the knee joints. This condition results from age related degeneration of joint cartilage and synovial fluid. This results in excessive stiffness, swelling, pain and decreased mobility due to loss of lubricant functions of joint cartilage. Treatment for Knee Osteoarthritis: Treatment for knee osteoarthritis consists of anti inflammatory drugs, lifestyle modifications and knee exercises. In advanced stages where pain is severe or conservative therapy fails, replacement of knee joint is required. In many cases, knee replacement is not feasible or desired due to various reasons. For such cases, other treatment option is available in form of Platelet rich Plasma (PRP) injection in knee joint. How is PRP therapy done? The procedure involves drawing a sample of blood from the patient and then placing it in a Centrifuge machine which extracts the Platelet rich plasma (PRP) constituent from blood.The sample constitutes of platelets (blood cells) which consist of numerous healing and inflammatory chemicals. This PRP sample is injected in the knee joint under sterile precautions. This decreases inflammation, and promotes healing. Benefits of PRP therapy: The body s first response to soft tissue injury is to deliver platelets. Platelets carry cells, proteins, and other growth / healing factors that initiate repair and recruit stem cells. PRP therapy s natural healing process intensifies the body s efforts by delivering a higher concentration of platelets within the damaged joint. Research has shown PRP therapy to be very effective at relieving pain and returning patients to their normal activities. Both Ultrasound and MRI images have shown definitive tissue repair after PRP therapy, confirming the healing process. The need for knee replacement can also be greatly reduced by promoting repair of cartilage before joint damage becomes extensive. In fact PRP therapy works best when done in early stages of Knee Osteoarthritis. Relieves pain without the risks of surgery or general anesthesia. No hospital stay is required. The procedure is performed safely and takes approximately two hour including preparation and recovery time. In fact, most people return to their jobs or usual activities right after the procedure. Most patients require 2 to 3 sessions of knee PRP therapy. Side effects of PRP Therapy: The procedure is free of side effects when done by experienced pain specialists. Since the therapy involves injecting patient's own blood derivative, it is a safe procedure.
2714 people found this helpful

Bilateral One Staged Total Knee Resurfacing Surgery - Is a Boon or Bane?

Dr. Rakesh G. Nair Nair 90% (15 ratings)
DNB (Orthopedics), Diploma in Orthopaedics, MBBS
Orthopedist, Mumbai
Bilateral One Staged Total Knee Resurfacing Surgery - Is a Boon or Bane?
My mother aged 65 years has severe arthritis of both knees, should she get both knees replaced in one sitting? You should do both knees in one sitting if the severity is same in both the knees and the patient is unable to differentiate the painful knee. In case the patient says one knee is more painful than address one knee at a lime. Your own knee is always the best till it lasts. What are the advantages of doing both the knees in one sitting? Exposure to the risk of anaesthesia reduced to only once Aids simultaneous rehabilitation especially in severely deformed knees Bilateralprocedure reduces cost Earlier return to baseline function and convenience for the patient and relatives Shorter cumulative hospital stays What are the risks associated with bilateral Total Knee Replacement (TKR) and are there any studies to support the same? The risks of cardiac and infection related complications for bilateral TKR are lower than the combined risk of two unilateral TKRs. A population-based comparison of the incidence of adverse outcomes after simultaneous-bilateral and staged-Bilateral Total Knee Arthroplasty published in The Journal of Bone And Joint Surgery. Result: Records were available for 11.445 simultaneous-bilateral arthroplasty Procedures and 23.715 staged-bilateral procedures. Conclusions: Simultaneous-bilateral total knee arthroplasty was associated with clinically important reduction in the incidence of infection and malfunction within one year after arthroplasty. What is the latest Technology available which could help improve surgical outcomes? Custom Fit Knee Resurfacing: A knee with your name on it i.e. customized specifically based on your dimensions. Understanding Custom Fit Knee Resurfacing: You are unique and so is your individual anatomy and thus lack of accuracy leads to discomfort and even further corrective surgeries That is why Custom Fit Knee replacement surgery, which utilizes MRI (Magnetic Resonance Imaging) technology to create personalized positioning guides for total Knee replacement is recommended. Practical Benefits Of Custom Fit Knee Replacement MRI of the affected knee is done based on which we can make a customized jig for better fitting of the implant for the patients No intra medullary instruments so minimal chances of fat embolism Minimally Invasive (just a 4-5 inch incision) Improves the speed of the operation theater time (40% reduced surgical time) Increases implant inventory efficiency (know sizing) Faster recovery of the patient Perfect patient alignment thus better mobilization What is the role of body exhaust 'space' suits in Bilateral TKR? 'Space' suits maintain a more sterile environment and offer more mobility to the surgeons. Space suits are used to help reduce contamination from the operating teams from entering the wounds. The impure air exhaled by the operating team is pushed down by the rotating fan in the helmet of space suits and absorbed by the laminar air flow in the 0.T.
3691 people found this helpful

Osteoarthritis - How Best to Manage it?

Dr. Ayusmati Thakur 91% (222 ratings)
MBBS, DNB (General Medicine), Certified in Evidence Based Diabetes Management, MNAMS
Internal Medicine Specialist, Kolkata
Osteoarthritis - How Best to Manage it?
The human body is able to move fluidly because there are various joints, muscles, tendons and cartilages that work together to make this happen. Movements of the hands, legs, back, hips, knees and wrists are controlled this way. For various reasons, however, these tissues grow stiff, thereby, reducing free movement. Any movement causes pain and stiffness and swelling of the joints, which forces the patient to reduce physical activity. This reduced activity further leads to the joints becoming stiff, thus putting the patient in a difficult position. What causes it? The ends of the bone are covered by softer tissue called cartilage, which is responsible for allowing the free movement. In patients with osteoarthritis, this cartilage is lost and the bones rub against each other, producing pain and a crackling sound with the movement. Some of the most common causes include the following: Age is the most common cause for osteoarthritis, with lifestyle habits playing a major role in this condition. Most joints would be affected here. Obesity is another major cause for osteoarthritis, as the additional weight of the person puts extra pressure on the knees and the legs, leading to the wearing of the joints. The back and lower extremities are more affected than the hands in this case. Joint injuries are another common cause for osteoarthritis, which is more localised to the area of injury. What are the signs and symptoms? As noted already, painful movement is the most common symptom of osteoarthritis. There could also be swelling and redness around the affected joint(s). Diagnosis: The doctor will usually be able to identify osteoarthritis after an examination, but in some cases, an X-ray or MRI may be required to confirm the diagnosis. Treatments available The treatment for osteoarthritis is multipronged. For immediate relief of the pain, non-steroidal and anti-inflammatory drugs are used. In cases of localised symptoms, even topical creams or gels may be used. Weight loss is extremely essential, if there is obesity that is causing the osteoarthritis. Vitamins and supplements in good amounts can improve bone health and help in preventing and reversing the damage in some patients. Heat therapy has proven to be quite useful in many cases to provide temporary relief As much as the movement of the joints is painful for the patient, it is only with regular exercise that the joints can be made more flexible and mobile. The affected joints need to be specially cared for by avoiding injury and reducing unnecessary movements. Role of physiotherapy in the management of OA - Strengthening exercises, Taping, Manual therapy, Education/lifestyle changes, Modalities, Agility and perturbation training. The definitive therapy of OA is joint replacement (total/partial knee/hip joint replacement). In addition, support groups and counselling may also help significantly in patients who find their quality of life being reduced due to this condition. Remember, not all is lost with osteoarthritis. It is definitely possible to get your life back to its earlier days when you were able to move about freely.
3179 people found this helpful

Steps Involved in Knee Replacement Procedure

Dr. Deepak Thakur 86% (99 ratings)
M.CH. (Ortho), MS - Orthopaedics, MBBS
Orthopedist, Delhi
Steps Involved in Knee Replacement Procedure
Knee replacement is a procedure where the weight-carrying surfaces of knee joint are replaced surgically to ease the pain or any disability. People suffering from osteoarthritis, rheumatoid arthritis or psoriatic arthritis undergo knee replacement. All these conditions revolve around stiffness and painful knee. This surgery is usually performed on people aged over 50. Surgery types Knee replacement is mainly of two main types: 1. Total knee replacement where both the sides of knee joints are replaced 2. Partial knee replacement where only single side of the joint is replaced Procedure In case of partial knee replacement with minimal invasion, a smaller incision, which is 3 to 5 inches, is required. This leads to minimal tissue damage and the surgeon can work between the fibres of the quadriceps muscles. Here, an incision through the tendon is not required. This may result in less pain, recovery time is reduced, and motion is better as scar tissue formation is less. In total knee replacement, four steps are performed: 1. Removal of damaged cartilage surfaces, which is at the ends of the femur and tibia, with a small quantity of underlying bone. 2. Replacement with metal components, which help as a recreated surface of the joint 3. Incision of knee cap with a resurface made of a plastic button, which is optional based on the case 4. Insertion of a medical grade plastic spacer amid the metal components. This creates an effortless gliding surface. After general or spinal anaesthesia, an incision of 8-12 inches is made in the front part of the knee. Joint part which is damaged is removed from the surface of the bones. The surfaces are then formed in a way to hold a metal or plastic artificial joint. The thigh bone shin as well as knee cap is attached to the artificial joint with either cement or a special material. After effects of the procedure After the surgery, patients may stay in a hospital for three to five days. Post surgery, notable improvement can be seen after a month or later. The patient is gradually relieved from pain with the construction of new gliding surface during surgery. There will be slow progress in the movement. In the beginning, one may walk with a support of parallel bars and then with the help of crutches, walker, or cane. After full recovery in about six weeks, people can enjoy normal activities except running or jumping. Presently, over 90% of total knee replacements function well even after 15 years of surgery. Hence, knee problem is no problem at all!
3999 people found this helpful

Popular Questions & Answers

I am 73 years Old male and have under gone Total Knee Replacement Surgery for both the Knees on 29.08.17 at Mumbai. I had 19 sessions of physiotherapist exercises at Mumbai and now back to my home in GHAZIABAD (U.P.) on 05.010.17. Though I have no pains and regularly doing the exercises as explained by Physio at Mumbai, I want a good Physio who can come on Sundays at my Residence in Ghaziabad and guide me properly.

Dr. Julie Mercy J David Raja 92% (2070 ratings)
Erasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPT
Physiotherapist, Chennai
This is a general strain due to excessive walking or standing and for this you can follow these measures: one keep a pillow right under the knee while sleeping, next is you can keep ice in the painful area for about 5--10 minutes. One time you can do hot water fermentation that would help to reduce the muscle Pain:Ice therapy would definitely help to reduce the inflammation. We also advise you to use knee cap which would help to prevent the knee from damaging further and also to maintain the quadriceps muscle tone. Simple Knee Exercises would help to strengthen the quadriceps muscle which is the key muscle. Specific knee exercises will also help ie. Keeping a soft ball underneath the knee and you have to keep pressing it. That's the simple exercise which will help you to strengthen the knee. We also advise you to use knee cap which would help to prevent the knee from damaging further and also to maintain the quadriceps muscle tone.

I am 60+ years old & suffering from arthritis for the past 10 years. Both knees are affected. I consulted a doctor and he has suggested knee replacement in both knee. Is knee replacement necessary? What are the advantages of knee replacement? Will I be able to walk properly after the operation?

Dr. Prem Chand 92% (1343 ratings)
MBBS, Craniosacral Balancing, Quantum Touch, Visceral manipulation
Pain Management Specialist, Panchkula
Knee replacement is a good alternative these days. Don't worry follow proper precautions as advised to you after operation (physiotherapy etc.) You will enjoy your life. For any type of stress in any field of life mind management is available for which you can contact us on Lybrate. More details about the treatment on our profile/personal statement column.
1 person found this helpful

I had bilateral total knee replacement surgery 15 days back. My right knee is almost healed now, able to bend as physiotherapist suggests with very less pain now. But my left knee is still very stiff very painful, bends very less, Also I get fever spike of 100°after every physio session. I am not getting satisfactory answers from surgeon, who says that it will gradually bend. Should I be worried now? What may b the causes and remedies? Stiffness,pain and fever are the main issues. Pl help.

Dr. Rakesh Singh 92% (283 ratings)
M.P.T-Ortho, Bachelor of physiotherapy
Physiotherapist,
most probably left knee was more accurate or fit in comparison of Rt knee before operation. do not worry regarding your issue. this is some time common. take cold pack twice or thrice daily. ask your physio to stretch left one more precisely. it will take some time more. can take pain killer too. if there is no discharge or pus like thing in lt knee ...do not take tension.
1 person found this helpful

My father having knee problem. We consulted the orthopedic doctor. He suggested should be replace knees. We are OK with that but we have a doubt his age around 62 if we go for knee replacement it will use for future or not. Please let me know. We have seen few after knee replacement still there are suffering and unable to walk also. Kindly let us know for knee replacement.

Dr. Hetal Alok Desai 87% (11 ratings)
Physiotherapist, Vadodara
Hello. You have not mentioned since how long he has been suffering from knee pain. If he has very chronic pain and he has gone through all other alternative ways and does not get relief and his pain is at very serious level he can go for knee replacement surgery ,if his knee bending is too much restricted and unable to walk then knee replacement is advisable, its completely dependent on his body response how he ll recover .As a Physiotherapist I advise you first go for alternative therapies if they don't work out you can definitely go for knee replacement it is a last and convenient option. Stem cell therapy and other therapies are also there but because of age it may not work out but knee replacement may but after surgery exercise and care should be taken. Thank you.
2 people found this helpful

My mother (Age 51, weight 69 kg) has osteoarthritis and the synovial fluid of the right knee (Arthritis grade 4) is nearly gone but the bones of the left leg started to bend and paining more severe from 2 month on wards. And BMD results shows osteoporosis (T-Score = -4.06) (Z Score = -2.63) but uric acid (3.7 mg/dL) and serum calcium is normal. She also has mild diabetes and High BP (140/80). Should we go for the knee replacement surgery or is there any alternative ayurvedic treatment of it? And Can knee replacement surgery successful in osteoporosis bones?

Dr. Sunil Kumar Tripathi 88% (25 ratings)
BPTh/BPT
Physiotherapist, Delhi
Hi dear, To know whether knee replacement would be successful or not for your mother, you need to get some set of physical tests done for her by a good Physiotherapists. There are no of conditions responsible for final outcome of knee replacement- 1- Muscular strength of legs before surgery 2- Clinical condition of joint 3- Metabolic disorders of patient 4- Post operative care and Strengthning of the replaced joint as well as entire limb Whether other alternative treatment will work for your mother, can be said only after examining her. If you wish you can consult me for proper guidance on alternative treatment, replacement and various other things related to her.
3 people found this helpful

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