Total Knee Replacement (Knee Surgery)

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What is a Total Knee Replacement?

Total Knee Replacement is surgery to replace diseased or damaged joint surfaces of the knee with metal and plastic prosthetic devices.

How is it done?

Surgery may be performed under a general or spinal anesthesia. During the procedure the surgeon shaves the joint cartilage at the ends of the femur and tibia (sometimes the cartilage of knee cap) and fits them with prosthetic caps. These are then re-attached to the remaining bone with specialized cement. You will return from surgery with a large dressing on the knee. A drainage tube will be in place to help drain excess fluids from the joint in the days following surgery. You will be required to wear pressure stockings immediately after surgery to prevent blood clotting.

Why is it done?

Most knee replacements are performed to relieve severe pain from arthritis or injury in the knee that limits an individual’s ability to do the things they want to do. It might also be performed to remove tumors of the knee.

Risks & complications

There are possible risks and complications associated with anesthesia, including respiratory or cardiac malfunction. Other complications include the possibility of:
  • Infection requiring antibiotics and in some cases hospitalization
  • Infection occurring around the joint years after the surgery
  • Blood clots in the legs (deep vein thrombosis), which can dislodge and move to the lungs (pulmonary embolism)
  • Injury to nerves or blood vessels
  • Loosening or dislocation of the prosthetic devices
  • Joint stiffness
Risks can be reduced by following the surgeon's instructions before and after surgery.

Alternatives

The surgeon may discuss alternative approaches to the total knee replacement procedure, including:

Non-Surgical Alternatives:
  • Walking aids such as a walking stick or cane or fitting with specialized braces
  • An exercise program to strengthen the muscles around the knee joint to improve positioning and relieve pain
  • Non-steroidal anti-inflammatory drugs like aspirin, ibuprofen and celebrex to relieve pain
  • Corticosteroids such as prednisone or cortisone can reduce joint inflammation
  • Herbal supplements like glucosamine and chondroitin
Surgical Alternatives:

Candidate eligibility

Candidates for total knee replacement should be free of infection.  You will receive an extensive pre-operative evaluation to determine if you are a good candidate for the total knee replacement procedure. The surgeon will make the final determination of each patient’s eligibility for the procedure after an examination and consultation with the patient. Post operative progress is determined largely by patient effort.
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