Total Knee Arthroplasty

When you have persistent knee pain that isn’t getting better, even with rest, ice, over-the-counter pain medications and other treatment, total knee arthroplasty could be a good option for you. Total knee arthroplasty is another name for total knee replacement. This involves replacing damaged parts of your knee joint with metal components to ease pain and make it easy for you to perform your daily activities.

Why Is It Done?

Your knee has several parts to it that help it move smoothly when you walk, bend and do other types of movements. These include your kneecap, lower thighbone, upper shinbone, ligaments and menisci. The bones in your knee have cartilage on the ends of them that keep them from rubbing against each other, as well as fluid that helps keep them smooth. When the amount of fluid decreases or when cartilage wears away, which can happen with certain conditions, it causes ongoing knee pain and inflammation.

You might experience knee pain and stiffness if you have arthritis, such as osteoarthritis or rheumatoid arthritis. Osteoarthritis occurs when your cartilage wears away due to age, while rheumatoid arthritis occurs when the synovial membrane around your knee joint becomes inflamed. You might also develop arthritis after having a severe knee injury.

Should I Have It Done?
Whether or not you should have total knee replacement done depends on the condition of your knee joint and how much it interferes with your daily activities, along with other factors. Your doctor might recommend this procedure if you have knee pain that doesn’t respond to nonsurgical forms of treatment or if you have pain that limits you ability to do normal activities. While most people who have total knee replacement done are over 50, there are no restrictions on age or weight. Your surgeon will review your medical history, perform a physical exam and take X-rays and other diagnostic tests of your knee to see how severe the damage is before discussing this procedure with you.

What Happens During a Total Knee Replacement?
Despite the name, a total knee replacement doesn’t actually involve replacing your entire knee. Instead, only the damaged or deteriorated parts of your knee joint are removed and replaced. When you have this done, your surgeon will do the following:

  • Remove damaged cartilage and part of the bone underneath
  • Place metal implants in your knee to replace the cartilage and bone that was removed
  • Resurface part of your kneecap with a plastic button, although this isn’t always done
  • Place a plastic spacer between the metal implants to allow your knee joint to move smoothly

Total knee arthroplasty usually takes up to 2 hours to perform. You will be placed under general anesthesia or given a nerve block anesthesia to numb your body from the waist down before surgery is performed.

What Happens After Surgery?

Your surgeon will provide you with medication if you have pain and soreness after your procedure. You can also expect to do physical therapy to make your knee stronger, which helps the recovery process. Overall, it can take several weeks or even months to fully recovery from total knee arthroplasty. Afterwards, you can expect to resume your normal activities without experiencing pain and stiffness.

Are There Any Risks?

Just as with any other type of surgical procedure, there are certain risks of total knee arthroplasty. The risks of complications are low overall and include the following:

  • Infection: Infections can develop around the surgical site or inside the joint and can be mild or more serious.
  • Ongoing pain: Although most people experience pain relief after a total knee replacement, a few continue having ongoing pain.
  • Nerve damage: This is a very rare complication that can occur when nerves around the knee joint are injured during surgery.
  • Blood clots: Blood clots are a more common risk with knee replacements, but there are several ways to lower this risk.
  • Scarring: Scarring in the knee joint can limit your range of motion.
  • Implant wear and tear: The metal implants in your knee can wear down over time, although this is more likely to occur if you do high-impact activities that place a lot of stress on your knee, such as running.