Total Knee Replacement

Before scheduling knee replacement surgery, you’ll first meet with one of our orthopaedic surgeons to discuss your symptoms in detail.

The consultant will begin by examining the affected leg, which may include evaluating the shin bone, knee joint, and assessing the leg’s ability to move passively without causing you discomfort. If knee replacement is deemed necessary, we’ll guide you through the entire process to ensure you feel informed and confident.

Your doctor may also perform tests, such as blood tests, X-Rays, ultrasound, or an electrocardiogram (ECG), to evaluate your overall fitness for the surgery. If you have specific health concerns, further tests might be required.

If you have any concerns or questions about the procedure, please don’t hesitate to reach out. Our team is here to support you and ensure you experience as little discomfort as possible throughout the process.

Preparing for surgery

Preparing for knee replacement surgery involves several steps, including:

• Stopping certain medications, such as blood thinners, before the surgery
• Undergoing pre-operative tests, such as blood work and imaging studies, to ensure that the individual is healthy enough for the surgery
• Meeting with the surgeon and anaesthesiologist to discuss the procedure and answer any questions
• Arranging for someone to drive the individual home after the surgery and provide assistance with daily activities during the recovery period

During total knee replacement surgery, you will be placed under general anaesthesia to ensure you are completely asleep and pain-free throughout the procedure. Once you are fully anaesthetised, the surgeon will position your leg in a way that provides optimal access to the knee joint.

The procedure begins with an incision around the knee, typically along the front of the joint. This incision is carefully made to expose the kneecap (patella) and surrounding tissues. The kneecap is then gently moved aside to give the surgeon access to the underlying knee joint, which includes the femur (thigh bone), tibia (shin bone), and the joint surfaces.

The next step involves removing the damaged or worn-out parts of the femur and tibia within the joint. The surgeon will precisely cut away the damaged ends of the femur and tibia, carefully shaping the remaining bone to prepare it for the artificial joint. The goal is to ensure that the bones are the correct shape and size to accommodate the prosthetic components.

Once the bone surfaces are properly prepared, a trial implant is temporarily inserted into the joint to test the fit and alignment. This allows the surgeon to check for proper movement and make any necessary adjustments before the final prosthesis is implanted.

After confirming that the trial implant fits properly, the surgeon will proceed with placing the permanent prosthetic components. The end of the femur is replaced with a curved metal component, and the top of the tibia is fitted with a metal plate. A plastic spacer, often made from high-density polyethylene, is placed between these two metal components to serve as a bearing surface, reducing friction and allowing for smooth movement of the knee joint.

In some cases, if the patella (kneecap) is also damaged, it may be replaced with a prosthetic component as well. The surgeon will assess the condition of the patella and decide if a replacement is necessary based on the extent of damage. If a replacement is required, the underside of the patella is resurfaced with a smooth plastic component.

Once the prosthetic components are in place, the surgeon carefully checks for proper alignment and movement to ensure the knee functions as expected. When the joint is properly aligned and the surgeon is satisfied with the results, the prosthesis is secured in place using surgical cement or, in some cases, through a cementless technique where the prosthetic components are designed to bond with the bone over time.

Finally, the incision is closed using stitches or staples, and a sterile dressing is applied to protect the wound. The knee is typically wrapped with bandages to help control swelling and keep the surgical area secure. The procedure generally takes between 1 to 2 hours, although the exact duration can vary depending on factors like the complexity of the surgery, the extent of the damage, and individual patient factors.

After the procedure, you will be moved to a recovery room where medical staff will monitor your vital signs as the anaesthesia wears off. You’ll also begin the early stages of rehabilitation, including pain management and physical therapy to start regaining motion in your knee.

After a total knee replacement (TKR) surgery, the recovery process typically unfolds in several stages. Immediately after surgery, you will be moved to a recovery room where medical staff will monitor your vital signs as the anaesthesia wears off. It’s common to experience some pain and swelling, but this will be managed with medications, including pain relievers and possibly a nerve block to reduce discomfort. Ice packs and elevating the leg can also help with swelling. In the first few hours, you’ll be encouraged to start moving your knee gently. A physical therapist may visit to assist you with early exercises and help you begin standing or walking with a walker or crutches.

Physical therapy plays a crucial role in recovery, and you will likely begin therapy while still in the hospital. The therapist will guide you through range-of-motion exercises to prevent stiffness and improve flexibility in the knee. Once you are discharged, physical therapy continues and becomes more focused on strengthening the muscles around the knee to improve joint stability and mobility. Depending on your surgeon’s recommendations, you may start placing weight on your knee with the aid of crutches, a walker, or a cane. Full weight-bearing is usually allowed after a few weeks, but the exact timeline will depend on how well you’re healing and your individual progress.

Pain management and reducing swelling are key aspects of recovery. You may be prescribed pain medications to help manage any discomfort in the first few weeks after surgery, along with advice on how to use ice and anti-inflammatory medications to reduce swelling. Elevating the leg when sitting or lying down can also improve circulation and minimise swelling. The incision site will need careful attention, as you’ll be instructed on how to keep the wound clean and dry. Stitches or staples are usually removed around 10-14 days post-surgery. It’s important to watch for any signs of infection, such as increased redness, warmth, swelling, or discharge, and contact your doctor immediately if these occur.

In the weeks following surgery, you’ll gradually return to normal activities, though it’s important to follow your doctor’s and therapist’s guidelines. Most patients can walk short distances, climb stairs, and even drive within 4-6 weeks, but full recovery can take several months. Driving is typically allowed once you’re no longer taking pain medications and have regained sufficient knee function, which is usually around 6 weeks, though this varies by individual.

The full recovery from a total knee replacement surgery can take anywhere from 6 months to a year. During this time, you will continue strengthening exercises to help improve muscle support around the knee. While most patients experience significant pain relief and improved mobility, some mild discomfort or stiffness may persist for the first few months, but the majority of people notice a dramatic improvement in both mobility and quality of life after the recovery period.

You’ll have regular follow-up appointments with your orthopaedic surgeon to monitor your progress and ensure that the prosthesis is functioning properly. X-rays may be taken to check the position of the prosthesis and the healing of the bone. Most patients return to their normal activities, but high-impact exercises like running or jumping may be discouraged to avoid wearing down the prosthesis prematurely. Maintaining a healthy weight, staying active with low-impact exercises (like walking, swimming, or cycling), and continuing knee-strengthening exercises are essential for long-term recovery and for prolonging the life of the knee replacement.