Total Knee Replacement (TKR)

Contents

Overview of the Procedure

Total Knee Replacement (TKR), also known as Total Knee Arthroplasty, is a surgical procedure that replaces damaged parts of the knee joint with artificial components. At KLSMC, our orthopaedic surgeons perform this procedure to relieve pain and restore function in knees severely damaged by arthritis or injury. The surgery involves removing damaged cartilage and bone from the thighbone (femur), shinbone (tibia), and kneecap (patella), and replacing them with prosthetic components made of metal alloys and polyethylene.

The procedure typically takes 1-2 hours to complete. During surgery, the surgeon makes a midline incision at the front of the knee, carefully exposes the bone and prepares the bone surfaces for the prosthetic components. These components are then applied to your knee using bone cement. The new surfaces glide smoothly against each other, eliminating painful bone-on-bone contact.

Types of the Procedure

Total Knee Replacement

This is the standard approach where the surgeon makes a conventional incision over the front of the knee and cuts through muscle, tendons, and tissue to access the joint. This technique uses specialized jigs and alignment rods to achieve mechanical alignment. Both bone cuts and soft tissue releases are vital in achieving a balanced knee. It is well-established with a proven excellent track record of long-term success and high patient satisfaction.

Unicompartmental knee arthroplasty (UKA)/Partial knee replacement.

This approach replaces only one compartment of the knee instead of all three compartments preserving bone and ligaments of the unaffected compartments. It is an option for patients with osteoarthritis of a single compartment.

Computer-Assisted Total Knee Replacement

This approach uses computer technology and sensors to guide the surgeon in positioning the cutting jigs and implant placement.

Robot-Assisted Total Knee Replacement

Robotic-assisted surgery utilizes 3D planning with robotic precision during the procedure. This technology allows for personalized implant positioning based on functional/kinematic alignments.

What Are the Benefits / Risks of Total Knee Replacement?

Benefits:

Pain Relief: Significant reduction or elimination of chronic knee pain
Improved Mobility: Restored ability to perform daily activities with greater ease
Enhanced Quality of Life: Return to a more active lifestyle without knee pain limitations
Correction of Deformity: Improvement of knee alignment in cases of severe deformity
Durability: Modern implants can last 15-20 years or longer in many patients

Risks:

Infection: A serious but uncommon complication that may require additional surgery
Blood Clots: Deep vein thrombosis (DVT) can develop in the leg veins
Implant Problems: Loosening, wear, or dislocation of the prosthetic components over time
Stiffness: Inadequate range of motion may develop in some patients
Nerve or Blood Vessel Damage: Rare injury to structures surrounding the knee

What Happens After the Total Knee Replacement?

Surgery is routinely done under spinal anesthesia with sedation. You’ll be pain free after the surgery till the spinal anesthesia wears off, usually in the evening. Pain management by means of oral analgesics or even injections depending on the level of pain experienced.

You’ll be walking using a walking frame with ongoing physiotherapy during admission post-operatively. Hospital stay is roughly 4-5 days. Be on walking frame ambulation for a month. Well enough to travel after 3 months.

How Long Is the Recovery Period from Total Knee Replacement?

Recovery from TKR is a gradual process that occurs in stages:

Hospital Stay (4-5 days): Initial recovery focuses on pain management, preventing complications, and beginning basic movement.
Early Recovery Phase (Weeks 1-3): During this time, you’ll need an assistive device (walker or crutches) for walking with close follow up for wound care. Physical therapy sessions will focus on increasing range of motion, strengthening muscles, and improving walking ability.
Intermediate Recovery Phase (Weeks 4-6): Transition from walking frame to a cane or aid-free ambulation during this period. Physical therapy continues with more challenging exercises. You may begin driving again if you have adequate control of your leg.
Advanced Recovery Phase (Weeks 7-12): Most patients can walk without assistive devices by this time. Activities become easier, though you may still have some limitations with squatting, kneeling, or high-impact activities.
Long-term Recovery (3-6 months): Continued improvement in strength and function. Many patients can return to low-impact recreational activities like golf, swimming, or cycling. Most patients are able to travel during this period.
Full Recovery (6-12 months): Maximum improvement usually occurs within 6-12 months of surgery.

What Can You Do to Help Recovery After Total Knee Replacement?

Follow Your Exercise Program: Perform prescribed exercises consistently to build strength and improve range of motion
Manage Swelling: Use ice therapy and elevation as recommended
Walk Regularly: Gradually increase walking distance as your strength improves
Maintain a Healthy Weight: Extra weight puts additional stress on your new knee
Use Assistive Devices: Follow your surgeon’s recommendations for using a walker, crutches, or cane
Attend All Physical Therapy Sessions: Consistent therapy is crucial for optimal recovery
Modify Your Home Environment: Remove tripping hazards and consider temporary modifications like a raised toilet seat
Follow Medication Guidelines: Take pain medications as prescribed to stay comfortable enough to perform your exercises
Watch for Complications: Contact your healthcare provider if you notice increasing pain, warmth, redness, drainage from the incision, or fever
Maintain a Positive Attitude: Recovery can be challenging, but a positive mindset helps overcome difficulties

Next Steps

If you’re considering Total Knee Replacement at KLSMC, here’s how to proceed:

Schedule a Consultation: Call our appointment line at +603-2096 1033
Prepare for Your Visit:
- Bring previous X-rays, MRIs, or other imaging studies
- Have a list of medications you’re currently taking
- Make note of previous treatments you’ve tried for your knee pain
- Prepare questions about the procedure, recovery, and expectations
Assessment Process: Your initial consultation will include a thorough physical examination, review of your medical history, and possibly new X-rays or other diagnostic tests.
Pre-Surgical Planning: If TKR is recommended, our team will discuss implant options, surgical approach, and set realistic expectations for recovery.
Medical Optimization: You may need to see other specialists to ensure you’re in the best possible health before surgery. This might include management of existing conditions like diabetes or heart disease.
Financial Considerations: Our patient care coordinators can provide information about procedure costs, insurance coverage, and payment options.

Don’t let knee pain limit your mobility and independence any longer. Contact KLSMC today to learn how our experienced surgical team can help restore your quality of life through Total Knee Replacement.

Frequently Asked Questions

How do I know if I'm a candidate for Total Knee Replacement?

TKR is typically recommended when knee pain is severe, interferes with daily activities, and hasn’t responded to conservative treatments like medication, injections, or physical therapy. Good candidates have significant damage to the knee joint confirmed by X-rays or other imaging. Your orthopaedic specialist will evaluate your specific situation to determine if TKR is appropriate for you.

How long will my new knee last?

Modern knee replacements are designed to last many years. Studies show that about 90-95% of knee replacements are still functioning well 15 years after surgery. Factors affecting longevity include your age, activity level, weight, and how well you follow recovery guidelines. Younger, more active patients may eventually need a revision procedure.

Will I set off metal detectors with my knee replacement?

Many patients with knee replacements will trigger metal detectors at security checkpoints. The metal components in your prosthesis are safe for MRIs, but you should inform security personnel about your implant. Some patients carry a medical alert card, though this is not typically necessary.

When can I drive after knee replacement surgery?

Most patients can resume driving 4-6 weeks after surgery, but this varies based on individual recovery and which knee was replaced. For right knee surgery, you’ll need adequate control of your leg for braking. Your surgeon will provide specific guidance based on your progress.

What activities can I participate in after recovery?

After full recovery, most patients can participate in low-impact activities such as walking, swimming, golfing, and cycling. High-impact activities like running, jumping, or contact sports are generally discouraged as they may shorten the lifespan of your implant. Your surgeon will provide specific guidance based on your individual situation and goals.