Specialist KNEE + HIP Surgeon

Total Knee Replacement

Total Knee Replacement

Arthritis of the knee occurs very commonly, particularly as one gets older. It can also occur in younger patients who may have sustained sporting injuries years earlier, or who have sustained other trauma to their knee.

A total knee replacement is a very successful procedure, with a success rate in the 90%-95% range. Most total knee replacements should last up to 20 years or even longer.

If the prosthesis does become loose or wears out, then a revision total knee replacement can be done.

Surgery Procedure

The Operation

The operation of total knee replacement involves removal of the damaged or arthritic ends of the bone. This involves removal of about 1cm of bone to allow the new prosthesis to fit onto the ends of the femur and tibia. Occasionally the under surface of the kneecap is replaced by a plastic button.

The femoral side has a curved metallic prosthesis attached to the bone; the tibial side has a flat metallic prosthesis attached to the bone and locked into this flat plate is a plastic cushion which articulates with the femoral side.

Knee Arthritis

The knee joint is a large, complex joint involving the articulating ends of the femur and tibia and also the patella (knee cap)which sits in a groove on the femur. The ends of the three bones are covered in a smooth articular cartilage, allowing cushioning and easy movement of the knee joint.

Arthritis destroys the smooth articular cartilage on the ends of the bones, interfering with the normal function of the knee joint. The usual problems with an arthritic knee are:

  • Pain – It is chronic and severe, often not helped by physiotherapy and anti-inflammatory medication, it limits walking distances, often at night and disturbs sleep
  • Stiffness
  • Catches and gives way
  • Swells

The Decision to Have a Total Knee Replacement

This should only be made after extensive discussion with your surgeon and you are happy with the explanations. You should also be aware of the risks and possible (although rare) complications.

The total knee replacements will impose some lifestyle restrictions, such as, you will not be able to run or jog, play impact sports or kneel.

The main reason for doing a total knee replacement is for the relief of pain.

Immediately After the Surgery

From the operating theatre you will be transferred to the recovery ward – you will have a large dressing on your knee and a drainage tube from your knee to ensure it does not fill with blood post-operatively.

You will have strong pain-killers and usually you will have a pain controlling device, which allows the patient to control the pain-killer dose, depending on the level of pain.

You will be on a continuous passive motion machine. Your leg sits in this machine which slowly moves up and down, regaining movement of the new knee in the early post-operative stage.

A physiotherapist will manage all your rehabilitation needs, from regaining muscle strength to teaching you how to walk again.
Most patients go home between five to seven days after the surgery.

Returning to Work

From the operating theatre you will be transferred to the recovery ward – you will have a large dressing on your knee and a drainage tube from your knee to ensure it does not fill with blood post-operatively.

You will have strong pain-killers and usually you will have a pain controlling device, which allows the patient to control the pain-killer dose, depending on the level of pain.

You will be on a continuous passive motion machine. Your leg sits in this machine which slowly moves up and down, regaining movement of the new knee in the early post-operative stage.

A physiotherapist will manage all your rehabilitation needs, from regaining muscle strength to teaching you how to walk again.
Most patients go home between five to seven days after the surgery.

Possible Complications

Blood clots or DVT

We routinely give drugs to “thin” the blood to minimise this risk.

Infection

Anti-biotics are given before and after surgery to prevent this.
Approximately one in 100 may become infected.

Loosening of the Prosthesis

Despite our best efforts at the time of surgery, and the quality of the prostheses, a small number may still come loose.

Stiffness

tiffness of the knee joint after surgery may occur, particularly if it was stiff before surgery.

Heavy scarring

This may cause knee stiffening.

Nerve damage

This often recovers.

Numbness

Around the wound.

For appointments, please call (08) 8267 1284