Total Knee Replacement (TKR) Surgery

Total Knee Replacement (TKR), also known as knee arthroplasty, is a highly effective surgical procedure designed to relieve pain, restore mobility, and improve quality of life for patients suffering from severe knee problems. For many individuals, knee pain and stiffness caused by arthritis or injury can limit daily activities and affect overall well-being. Total Knee Replacement offers a long-term solution by replacing the damaged knee joint with an artificial implant.

Understanding the Knee’s Anatomy

Total knee replacement (TKR), also called knee arthroplasty, is a surgical procedure designed to resurface a severely damaged knee joint, primarily due to arthritis or injury. It involves replacing worn-out joint surfaces with durable metal and plastic prosthetic components to restore mobility and relieve chronic pain.

TKR is most commonly performed for osteoarthritis, a degenerative condition where cartilage progressively wears down, leading to bone-on-bone friction, pain, stiffness, and restricted movement.

What Is Partial Knee Replacement?

The knee is one of the largest and most complex joints in the human body. It functions like a hinge, allowing your leg to bend and straighten, while also providing rotational movement for activities such as walking, climbing, or squatting.

The knee joint is made up of:

• Bones: The femur (thighbone), tibia (shinbone), and patella (kneecap).
• Cartilage: Smooth tissue that cushions the bones and allows easy, pain-free movement.
• Synovial membrane: A thin tissue that produces fluid to lubricate the joint.
• Ligaments and tendons: Structures that provide stability and support.

When this natural system is disrupted—most often due to osteoarthritis, rheumatoid arthritis, or post-traumatic injury—the cartilage wears down, bones may rub together, and severe pain or stiffness occurs.

When is Total Knee Replacement Recommended?

Knee replacement surgery is generally considered when conservative treatments no longer provide relief. Non-surgical options such as medications, physiotherapy, lifestyle modifications, and injections are usually tried first. If knee pain persists and daily activities like walking, climbing stairs, or even sleeping become difficult, surgery may be recommended.

Common reasons for a total knee replacement include:

• Severe Osteoarthritis: Age-related wear and tear that damages the joint.
• Rheumatoid Arthritis: Autoimmune disease that inflames and erodes cartilage.
• Post-Traumatic Arthritis: Resulting from fractures or ligament injuries.
• Severe Knee Deformity: Such as bow-legged or knock-knee alignment.
• Persistent Pain and Loss of Function: That does not improve with non-surgical treatments.

Benefits of Total Knee Replacement

The primary goal of knee replacement is to relieve pain and restore function. Most patients experience:

• Significant reduction or elimination of chronic knee pain.
• Improved mobility and range of motion.
• Better ability to walk, climb stairs, and participate in low-impact activities.
• Enhanced quality of life and independence.

With advancements in surgical techniques and implant design, modern knee replacements are highly durable, with many lasting 15–20 years or longer.

Preparing for Surgery

A thorough preoperative evaluation is conducted to ensure the patient is in optimal health for surgery. This includes:

1. Physical Examination: Assessing the extent of joint damage and alignment.
2. Imaging Tests: X-rays or MRI scans to evaluate bone and cartilage condition.
3. Blood Tests and Medical Clearance: To check overall fitness for surgery.
4. Patient Education: Discussing the procedure, recovery timeline, and realistic expectations.

Patients are often advised to:

• Strengthen the muscles around the knee through physiotherapy.
• Maintain a healthy weight to reduce stress on the joint.
• Manage any chronic medical conditions, such as diabetes or hypertension.

How Total Knee Replacement is Performed

Total Knee Replacement is typically performed under spinal or general anesthesia and takes about 1–2 hours. The steps include:

1. Incision: A precise cut is made over the knee to access the joint.
2. Removal of Damaged Surfaces: The worn-out cartilage and small portions of the bone are carefully removed.
3. Implant Placement: Artificial components made of metal alloys and high-grade plastic are fixed to the femur, tibia, and sometimes the patella.
4. Joint Realignment: The surgeon ensures proper balance and movement before closing the incision.
5. Closure: The incision is sutured, and the knee is dressed for recovery.

Modern techniques, such as minimally invasive surgery and computer-assisted navigation, allow for smaller incisions, less tissue trauma, and faster recovery.

Recovery and Rehabilitation

Successful recovery after Total Knee Replacement relies heavily on postoperative care and physiotherapy. Most patients can start moving the knee within 24 hours of surgery under supervision.

Typical Recovery Timeline

• Hospital Stay: 2–4 days, depending on overall health and progress.
• Initial Recovery (First 2–6 weeks): Use of a walker or crutches, with gradual improvement in walking and knee mobility.
• Physiotherapy: Focused on strengthening muscles, restoring flexibility, and improving balance.
• Return to Daily Activities: Most patients can resume light activities in 6–8 weeks and low-impact exercises like swimming or cycling after 3 months.
• Full Recovery: Typically achieved in 6–12 months, with continued improvement in function and comfort.

Potential Risks and Complications

While Total Knee Replacement is a highly successful procedure, all surgeries carry some risks. Potential complications include:

• Infection: At the incision site or around the implant.
• Blood Clots: Which can be minimized with early mobilization and medication.
• Stiffness or Reduced Motion: Often preventable with early physiotherapy.
• Implant Wear or Loosening: Rare with modern materials but possible over time.
• Nerve or Vessel Injury: Very uncommon.

Choosing an experienced orthopaedic surgeon and following postoperative instructions significantly reduces these risks.

Life After Total Knee Replacement Surgery

Most patients experience long-lasting pain relief and improved mobility, allowing them to return to many activities they enjoy. To ensure the longevity of the implant:

• Maintain a healthy weight to reduce joint stress.
• Engage in low-impact exercises like walking, cycling, and swimming.
• Avoid high-impact sports or heavy lifting that can strain the joint.
• Attend regular follow-ups to monitor implant condition.

Why Choose Our Clinic for Total Knee Replacement?

Our knee specialist clinic is dedicated to delivering personalised care with advanced surgical techniques. Here’s why patients trust us:

• Experienced Surgeon: Specializing in joint replacement with a track record of successful outcomes.
• Advanced Facilities: Equipped with modern surgical and imaging technology.
• Comprehensive Care: From diagnosis and surgery to rehabilitation and long-term follow-up.
• Patient-Centered Approach: Focused on comfort, safety, and the best possible recovery.

FAQs About Total Knee Replacement

1. How long does a knee replacement last?

Modern knee implants are designed to last 15–20 years or longer, depending on factors like activity level, weight, and overall joint health. Following your surgeon’s care instructions and maintaining a healthy lifestyle can help extend the implant’s lifespan.

2. Will I be able to kneel after a total knee replacement?

Many patients can kneel after full recovery, but it may feel uncomfortable initially due to sensitivity around the incision or the artificial joint. Your surgeon or physiotherapist can guide you on safe kneeling positions if necessary for your daily activities.

3. Can both knees be replaced at the same time?

Yes, bilateral knee replacement is possible for patients with severe arthritis in both knees. However, your overall health, age, and fitness level will determine if this is advisable. Your surgeon will discuss the safest approach for your situation.

4. When can I drive after knee replacement surgery?

Most patients can return to driving 4–6 weeks after surgery, provided they can comfortably bend the knee and react quickly. This timeline may vary depending on whether your right or left knee was operated on and the type of vehicle you drive.

5. Are there alternatives to total knee replacement?

Yes, for some patients with less severe joint damage, alternatives like partial knee replacement, cartilage restoration, physiotherapy, or joint injections may be considered. Your orthopaedic surgeon will assess your condition to recommend the most suitable treatment.